Online Enrolment Print Form Please note: Max Total file size is 8MB Additional form:Internet & ICT use agreementDownload Form Student DetailsStudent's Name* First Last Student's Preferred Name First Last Date of Birth* DD slash MM slash YYYY Gender* Male Female Gender Diverse If "Gender Diverse", please specify* Current Year Level OptionalEldest Child at School OptionalCurrent School OptionalDate of Enrolment at Maniototo Area School DD slash MM slash YYYY Student's Mobile No (if applicable)Address* Street Address Address Line 2 City Suburb Post Code EthnicityIwi/Hapu Affiliation Ethnic Group/s* Language Spoken at Home* Country of Birth* AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Nationality* AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Parent/Caregiver Details (1)Name* Mr.Mrs.MissMs.Dr.Prof. Prefix First Last Primary Caregiver* Yes No Does the student live with you?* Yes No Access Rights?* Yes No Relationship to Student* Address* Same as Student Home Address Street Address Address Line 2 City Suburb Post Code Occupation* Place of work* Email* Home PhoneWork PhoneMobile Phone*Parent/Caregiver Details (2)Name Mr.Mrs.MissMs.Dr.Prof. Prefix First Last Primary Caregiver Yes No Does the student live with you? Yes No Access Rights? Yes No Relationship to Student Address Same as Student Home Address Street Address Address Line 2 City Suburb Post Code Occupation Place of work Email Home PhoneWork PhoneMobile PhoneEmergency Contact (1)Name* Mr.Mrs.MissMs.Dr.Prof. Prefix First Last Relationship to Student* Place of Work (if applicable) Address* Street Address Address Line 2 City Suburb Post Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home PhoneWork PhoneMobile Phone*HealthPlease select if students suffers from: Asthma (requiring an inhaler) Diabetes Epilepsy Severe allergies Mental Health conditions If applicable please provide further details:AllergiesPlease list any medical conditions, current medication and information the school should be aware of:SpeechTetanus: Please enter date of last tetanus booster. DD slash MM slash YYYY Vision: Should your child wear glasses in class?* Yes No Hearing: Does your child require special seating arrangements?* Yes No Fully Immunised* Yes No Immunisation Select All Hepatitis B Polio Diphteria Tetanus Pertussis HIB Measles Mumps Rubella Pneumococcal Covid-19 Doctor's Name* Phone*Medical Center Name* Medical Centre Address* Street Address Address Line 2 City Suburb Post Code Has your child received assistance from outside agencies i.e. Special Education, Hospitals, ACC etc?Has your child received assistance/extra assistance/extension/gifted and talented in small groups in a previous school?Has your child had any stand-down, suspensions, or exclusions at previous schools?Custody/Access ArrangementsCourt Order Issued* Yes No Court Order DocumentsAccepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.Access ArrangementEarly Childhood EducationPrior-Participation in Early Childhood EducationPlease select (up to 3 services) for the last Early Childhood Education service(s) attended in the six months prior to starting school Kohanga Reo Play Center Kindergarten or Educations and Care Centre Home based service Playgroup The Correspondence School - Te Aho Te Kura Pounamu Hours per Week at Kohanga Reo* Hours per Week at Play Center* Hours per Week at Kindergarten or Educations and Care Centre* Hours per Week at Home based service* Hours per Week at Playgroup* Hours per Week at The Correspondence School - Te Aho Te Kura Pounamu* DocumentsStudent's Birth Certificate/Passport*If student is a New Zealand citizenAccepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.Student's Passport*If student is not a New Zealand citizen.Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.Parent's Passport*If student is not a New Zealand citizen.Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.Parent's Visa*If student is not a New Zealand citizen.Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.Immunisation Documents*Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.Internet & ICT use agreement*Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.Additional FieldsPlease list full name & date of birth of brothers/sisters currently enrolled at or will be attending MAS.Are there any other details that may be helpful for us in knowing, understanding and assisting your child/children/family? For example adopted child, blended family, religion etc?Is there anyone who should NOT have legal access to your son/daughter?Photograph I DO NOT want my child's photograph to be used positively in the press, on the school website or Facebook Privacy & PolicyEducation Outside The Classroom Education outside the classroom (EOTC) is the name given to all activities that occur outside the classroom, both on and off the school site. This includes curricular and extra-curricular activities. Our staff believes in using a range of environments and experiences to enhance student learning. Our staff value giving students EOTC opportunities. Hence we need your consent for your son/daughter to take part in EOTC learning. The consent is to cover: Activities in the school grounds conducted outside the classroom and may include activities where some level of risk may have to be managed, for example use of the climbing wall. Off-site activities in the local community including visits to local museums, information centre and sport and recreation facilities or events of interest. Note: All EOTC activitiy categories require staff to undertake an analysis or risks, and identify management strategies to eliminate, isolate and minimise risk. All trips/events will be notified via newsletter or website. Specific consent will be sought where higher risk or overnight activities are to be undertaken.Permissions* I apply to enrol my child at Maniototo Area School and agree to comply with the uniform, attendance, discipline and all other requirements covered in the school rules and policies I/We will keep the school up to date with medical, family and all other changes of information I/We agree to allow the school to use named and unnamed images of my child for school communications and marketing I/We have read and understood the enrolment form I/We have read and understood the EOTC section and give permission for my child to participate SignatureBy signing this below, I confirm that the information given in this form is true, complete and accurate.Full Name* Date* DD slash MM slash YYYY CAPTCHACommentsThis field is for validation purposes and should be left unchanged.
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