APPLICATION FORM – Ongata Royal

First Name*

Last Name*

Class/Grade*

Residential Address 1*

Residential Address 2

Town / City

Postcode

First Name*

Last Name*

ID Number*

Phone*

Email*

Occupation*

First Name*

Last Name*

ID Number*

Email*

Phone*

Occupation*

Separator

How did you hear about us?

Child's Medical Alert

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First Name

Last Name

ID Number

Phone

Separator

Special Needs

Additional Information

Separator

Pediatrician's Name

Pediatrician's Phone Number

Insurance Company

Policy Number

Permissions*

I have read and accepted the schools terms and policies.*

I AGREE for my child to be photographed and photos to be displayed

I will complete and return the following before my child enrolls: