Application for Boarding

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Student Details

Student's Surname

First Name

Preferred Name

Date of Birth

Address

Ethnicity

Iwi (if applicable)

Home Phone

Student Mobile

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Current School

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Referee Contact Number

Referee Email Address

Current Year Level

Year Enrolling For

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Caregiver Details

Caregiver One

Full Name

Relationship to Student

Address

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Home Phone

Mobile

Work Phone

Occupation

Caregiver Two

Full Name

Relationship to Student

Address

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Home Phone

Mobile

Work Phone

Occupation

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Application for Boarding

Student Details

Caregiver Details

CONTACT