Birkdale Intermediate
Online Enrolment

Tēnā koe,


Welcome to the Birkdale Intermediate School Enrolment form.

Please complete as much information as possible to help us process your child's enrolment.  

Note: * indicates compulsory fields to be completed.  Without completing these fields, you cannot submit your enrolment.
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 Of Citizenship *
Language At Home
Ethnicities * Maximum 4 Allowed
Iwi Maximum 3 Allowed
Verification Document *
Document Expiry Date
select
Document Serial Number *
Date Of Arrival In NZ
select
Previous School *
Eligibility Criteria *

Caregiver Details (Minimum 1)

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 *

Type Of Student
Starting Year Level (at this school) *
Date First Started Any School
select
Start Date At This School *
select
Zoning Status *
Early Childhood Education
Boarding Status
Photo Publication Consent
Internet 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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