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).

Please give details of any behavioural, pastoral or family circumstances that we need to be aware of on a separate sheet and upload with your application.
Application Form

Student Details

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 *
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 *

Type Of Student
Starting Year Level (at this school)
Date First Started Any 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 Number *Only Numbers and spaces are allowed
Address Street
Suburb
City
Pain Relief Permission *
Medical Consent *
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