Leeston School
Online Enrolment
Application Form

Student Details

Legal Surname *
Legal First Name *
Middle Name *
Preferred Surname *
Preferred First Name *
Date of birth *
select
Gender *
Country Or Jurisdiction Of Citizenship *
Language At Home
Ethnicities * Maximum 4 Allowed
Iwi Maximum 16 Allowed
Verification Document *
Document Expiry Date
select
Document Serial Number *
Date Of Arrival In NZ
select
Previous School
Eligibility Criteria *

Caregiver Details (Minimum 3)

Caregiver # 1 (This caregiver must live with the student)
Relationship *
Gender *
Select As Applicable *
Title *
Surname *
First Name *
Email *
Phone # Home *Only Numbers and spaces are allowed e.g. 06 1234567
Phone # Work *Only Numbers and spaces are allowed e.g. 06 1234567
Phone # Cell *Only Numbers and spaces are allowed e.g. 012 1234567
Search Address
Street *
Suburb *
City *
Post Code *
State / Province
Country *
Remove this caregiver
Caregiver # 2
Relationship *
Gender *
Select As Applicable *
Title *
Surname *
First Name *
Email *
Phone # Home *Only Numbers and spaces are allowed e.g. 06 1234567
Phone # Work *Only Numbers and spaces are allowed e.g. 06 1234567
Phone # Cell *Only Numbers and spaces are allowed e.g. 012 1234567
Search Address
Street *
Suburb *
City *
Post Code *
State / Province
Country *
Remove this caregiver
Caregiver # 3
Relationship *
Gender *
Select As Applicable *
Title *
Surname *
First Name *
Email *
Phone # Home *Only Numbers and spaces are allowed e.g. 06 1234567
Phone # Work *Only Numbers and spaces are allowed e.g. 06 1234567
Phone # Cell *Only Numbers and spaces are allowed e.g. 012 1234567
Search Address
Street *
Suburb *
City *
Post Code *
State / Province
Country *

Type Of Student
Starting Year Level (at this school) *
Date First Started Any School
select
Start Date At This School
select
Zoning Status *
Enrolment Priority (for out of zone enrolments)
Early Childhood Education
Photo Publication Consent *
Internet Permission *
EOTC Permission *

Medical Information

Doctor
Medical Centre
Phone NumberOnly Numbers and spaces are allowed
Alternative Phone NumberOnly Numbers and spaces are allowed
Address Street
Suburb
City
Pain Relief Permission
Medical Consent
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