Student Information

Family Name
First Names
Preferred Name
Residential Address
Number and Street Name/ Rapid Number and Road Name, Suburb name / Rural Delivery Number, Town / City/ Area / Country
Present Year Level
Enrolling Into Year Level
School Currently Attending
Boarding Has an application been made for Enwood House, our student residence?

Contact the Director of Boarding on 2169148 for information.
House Affiliation
(if any, please select one)


Ethnicities

(required for Ministry of Education Statistical returns)
 

(Please Specify)
(Please Specify Iwi Affiliations)
(Please Specify)

Specify Other Details / Affiliations
Date of Birth

Student Type

(required for Ministry of Education Statistical returns)
 
(New Zealand Born)

 
I agree to abide by the rules and requirements in the Plan book, and/or 'Achieve' book as given to each family. Type your full name in the field below which will be considered your electronic signature.
Type Your Full Name


Caregivers

(Caregiver is a term used by the Ministry of Education to describe the person(s) taking care of the student. This may include a stepmother, stepfather, partner, relative, homestay or legal guardian - whoever has day to day responsibility for the student.)
Student Lives With

Mother or Caregiver 1

(at student's home address)
Relationship
(mother, grandparent, aunt, step mother etc)
Family Name
First Name
Title
           
Physical Address (If different from student)
Include: Number and Street Name/ Rapid Number and Road Name, Suburb name / Rural Delivery Number, Town / City/ Area / Postal Code / Country
Postal Address (If different from above)
Include: Number and Street Name/ Rapid Number and Road Name, Suburb name / Rural Delivery Number, Town / City/ Area / Postal Code / Country
Home Phone
Cell Phone
Occupation (required for Ministry of Education Statistical purposes)
Place of Work
Work Phone
Email Address
Please tick as appropriate:




We like to encourage parental involvement. Please indicate where you might be able to assist:






I request that my daughter be admitted into Southland Girls' High School. I agree that she, and I as a parent or guardian, are bound by these rules and regulations as published and given to each family in the 'Achieve' booklet each year and will support them accordingly. Type your full name in the field below which will be considered your electronic signature.
Type Your Full Name

Names of Sisters / Family Members currently attending SGHS

Name Relationship Year Level

Father or Caregiver 2

(at student's home address)
Relationship
(father, grandparent, uncle, step father etc)
Family Name
First Name
Title
           
Physical Address (If different from student)
Include: Number and Street Name/ Rapid Number and Road Name, Suburb name / Rural Delivery Number, Town / City/ Area / Postal Code / Country
Postal Address (If different from above)
Include: Number and Street Name/ Rapid Number and Road Name, Suburb name / Rural Delivery Number, Town / City/ Area / Postal Code / Country
Home Phone
Cell Phone
Occupation (required for Ministry of Education Statistical purposes)
Place of Work
Work Phone
Email Address
Please tick as appropriate:




We like to encourage parental involvement. Please indicate where you might be able to assist:






I request that my daughter be admitted into Southland Girls' High School. I agree that she, and I as a parent or guardian, are bound by these rules and regulations as published and given to each family in the 'Achieve' booklet each year and will support them accordingly. Type your full name in the field below which will be considered your electronic signature.
Type Your Full Name

Duplicate Reports

  Is a duplicate report required for a non-custodial parent?

If yes, please give the name and address for this report to be sent to:

Emergency Contact

We will always attempt to contact the main caregivers should your daughter be unwell, or in the case of an emergency. However we do require an alternative contact person to act on your behalf should we be unable to contact you. Emergency contact details:
Relationship
(grandparent, neighbour, aunt, uncle etc)
Family Name
First Name
Title
           
Home Phone
Cell Phone
Place of Work
Work Phone

Medical Information

Doctor
Dentist
Medication regularly needed at school
Medical conditions: (Allergies, asthma etc)
Problem Degree Details (as appropriate) Medication at school? Y/N
Please give details of any issues with:
Hearing Hearing Aid Worn?
Vision Glasses Worn?
Speech

File Attachments

Please attach the following files in PDF format only (if applicable):
Copy of Birth Certificate Copy of Visa (if appropriate)
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