Peachgrove Intermediate
Online Enrolment

Please enter details using proper case eg. Jane Smith
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 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 *

Starting Year Level (at this school)
Enrolment Priority
Date First Started Any School
select
Start Date At This School
select
Zoning Status
Photo Publication Consent
Internet Permission *
EOTC Permission

Medical Information

Doctor
Medical Centre
Phone NumberOnly Numbers and spaces are allowed
Pain Relief Permission *
Medical Consent *
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