Broadfield School
Online Enrolment
Please complete all sections of this form. Once complete, please attach the following documents: Birth Certificate / Passport, Immunisation Certificate, Two forms of proof of address (eg Power or Rates account), Internet Agreement for relevant year level , Additional Information/Permissions for Enrolment Form and EOTC Blanket Consent Form (all downloadable from our website)
Application Form
Legal Surname *
Legal First Name *
Middle Name
Preferred Surname
Preferred First Name
Date of birth *
select
Gender *
NSN
Cell phone #Only Numbers and spaces are allowed e.g. 012 1234567
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 2)

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 *

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 *
Type Of Student
Starting Year Level (at this school)
Enrolment Priority
Date First Started Any School
select
Zoning Status
Early Childhood Education *
Doctor
Medical Centre *
Phone NumberOnly Numbers and spaces are allowed
Address Street
Suburb
City
Pain Relief Permission
Medical Consent

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