Enrolment Form

1STUDENT DETAILS

2LIVING & ELIGIBILITY

3FAMILY INFORMATION

4DECLARATION

ENTRY YEAR*
YEAR LEVEL*
FIRST NAME*
LAST NAME*
PREFERRED NAME
DATE OF BIRTH*
DD slash MM slash YYYY
STUDENT MOBILE
STUDENT EMAIL ADDRESS
Enter Email Confirm Email
ETHNICITY*
* IWI/TRIBAL AFFILIATION*
OTHER*
STUDENT IS CURRENTLY ATTENDING
NAME OF SCHOOL*
PRESENT YEAR LEVEL*
HEALTH INFORMATION
DOES THE STUDENT HAVE A MEDICAL CONDITION, DISABILITY OR ALLERGY THE SCHOOL SHOULD BE AWARE OF?*
- Yes
- No
FURTHER DETAILS*
I GIVE PERMISSION FOR MY SON TO BE GIVEN PARACETAMOL*
- Yes
- No
I GIVE PERMISSION FOR MY SON TO BE GIVEN IBUPROFEN*
- Yes
- No
OTHER INFORMATION
OTHER INFORMATION

DOES THE STUDENT RESIDE IN THE SCHOOL ZONE?*
- Yes
- No
We require two forms of proof eg a rental agreement, rates statement, power or phone account.
STUDENT RESIDES AT*
- One Address
- Two Addresses
HAS THE STUDENT HAD A BROTHER OR FATHER WHO PREVIOUSLY ATTENDED OR CURRENTLY ATTEND SBHS?*
- Yes
- No
NAME*
RELATIONSHIP*
CURRENT/YEARS ATTENDED*

PARENTS/CAREGIVERS AT RESIDENCE 1
PARENT/CAREGIVER 1*
First Last
RELATIONSHIP TO STUDENT*
MOBILE
EMAIL ADDRESS*
PARENT/CAREGIVER 2
First Last
RELATIONSHIP TO STUDENT
MOBILE
EMAIL ADDRESS
HOME TELEPHONE
HOME EMAIL ADDRESS
RESIDENTIAL STREET ADDRESS, SUBURB AND POSTCODE*
POSTAL ADDRESS (if different from street address)
PARENTS/CAREGIVERS AT RESIDENCE 2
PARENT/CAREGIVER 1*
First Last
RELATIONSHIP TO STUDENT*
MOBILE
EMAIL ADDRESS*
PARENT/CAREGIVER 2
First Last
RELATIONSHIP TO STUDENT
MOBILE
EMAIL ADDRESS
HOME TELEPHONE
HOME EMAIL ADDRESS
RESIDENTIAL STREET ADDRESS*
POSTAL ADDRESS (if different from street address)
Additional contact details eg parent not living with student
- I want to add additional contact details
NAME
First Last
RELATIONSHIP TO STUDENT
TELEPHONE
EMAIL ADDRESS
MOBILE
RESIDENTIAL STREET ADDRESS
POSTAL ADDRESS (if different from street address)
EMERGENCY CONTACT DETAILS

(Relative, friend or neighbour who can be contacted)
NAME
First Last
RELATIONSHIP TO STUDENT
TELEPHONE
MOBILE
OTHER INFORMATION
OTHER INFORMATION