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)
Date First Started Any School
select
Start Date At This School
select
Zoning Status
Enrolment Priority (for out of zone enrolments)
Photo Publication Consent
Internet Permission *
EOTC Permission

Medical Information

Doctor
Medical Centre
Phone NumberOnly Numbers and spaces are allowed
Pain Relief Permission *
Medical Consent *
Online Enrolment Powered by Musac Ltd.

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