PREFERRED
FIRST NAMES / LEGAL
PREFERRED
APPLICATION DATE / DATE OF BIRTH
Birth Certificate or Passport required / GENDER
Boy Girl
HOME ADDRESS / PREVIOUS SCHOOL
Street / Name
Town / Place
Phone / Current Year Level
COUNTRY OF BIRTH: LANGUAGE USED AT HOME:
ETHNICITY Tick All That Apply
NZ Maori -Specify Iwi / Iwi 1:
Iwi 2:
Iwi 3:
NZ European/ Pakeha / Samoan / Tongan / Chinese
Other -Specify
PRESCHOOL EXPERIENCE
SERVICE / NAME OF PROVIDER / HOURS PER WEEK
Kohanga Reo
Playcentre
Kindergarten
Homebased
Playgroup
Correspondence School
Other
Did your child attend the above services regularly ? / YES – for the last years
“Regularly” means child was booked into sessions each week/fortnight & went unless sick etc / NO – not regularly, only occasionally
IMMUNISATION
Primary schools are required to keep a register recording the immunisation status of all enrolled children born on or after 1 Jan 1995.
IMMUNISED/CERTIFICATE PROVIDED / NOT IMMUNISED
MOTHER/CAREGIVER - PARENT PLACE OF BIRTH:
Surname / First Name
Home Address / Home Phone
Mobile Phone
Employer
Occupation / Work Phone
FATHER/CAREGIVER - PARENT PLACE OF BIRTH:
Surname / First Name
Home Address / Home Phone
Mobile Phone
Employer
Occupation / Work Phone
LEGAL ISSUESThere are custody or access issues I/we need to discuss YES NO
PAGE 2PREFERENCE OF ENROLMENT CERTIFICATE (Attached)
MUST BE COMPLETED PRIOR TO ENROLMENT
Preference of enrolment at St Joseph’s CatholicSchool shall be given only to those children whose parents have established a particular or general religious connection with the Special Character of the school.
The Parish Priest or Ethnic Chaplain will determine if the parents have met this requirement under specific criteria set down by the NZ Catholic Bishops.
You must shine among them like stars lighting up the sky
St Paul to the Philippians 2:15