Enrolment Form

STUDENT FIRST NAME*
STUDENT LAST NAME*
ENTRY YEAR*
YEAR LEVEL*
DATE OF BIRTH*
COUNTRY OF BIRTH*
Attach a copy of birth certificate.
NZ RESIDENCY*
- Yes
- No
Proof of residency required if not New Zealand born.
PRIMARY LANGUAGE SPOKEN AT HOME*
ETHNICITY (can be up to 3)*
Hold down CTRL to select multiple items
IWI/TRIBAL AFFILIATION (can be up to 3)
OTHER*
STUDENT IS CURRENTLY ATTENDING
NAME OF SCHOOL*
PRESENT YEAR LEVEL*
STUDENT RESIDES AT*
- One Address
- Two Addresses
STREET NUMBER AND NAME*
SUBURB*
TOWN / CITY*
POSTCODE
STUDENT MOBILE NUMBER
2ND ADDRESS (if applicable)
PREFERRED EMAIL ADDRESS*
Enter Email Confirm Email

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PARENT/CAREGIVER 1*
First Last
RELATIONSHIP TO STUDENT*
MOBILE*
EMAIL ADDRESS*
RESIDENTIAL ADDRESS (if different to students)
BUSINESS NAME
OCCUPATION
BUSINESS PHONE
PARENT/CAREGIVER 2
First Last
RELATIONSHIP TO STUDENT
MOBILE
EMAIL ADDRESS
HOME TELEPHONE
RESIDENTIAL ADDRESS (if different to students)
OCCUPATION
BUSINESS NAME
BUSINESS PHONE
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
OTHER INFORMATION

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SUPPORT OF THE SPECIAL CHARACTER AT HIBS
Enrolment Preferences: As stated in the HIBS Integration Deed of Agreement, a preference of enrolment at HIBS shall be given to those pupils with parents who have established a particular or general connection with the Special Character of the School. Please explain your connection as parents to the HIBS Special Character Key Principles included in your Enrolment Pack (also found on the school’s website under Special Character).
Support of the Special Character*

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PRIORITY 1 – IS YOUR SON A BROTHER OF A CURRENT STUDENT AT HIBS?*
- Yes
- No
NAME OF BROTHER and HOUSE GROUP
CURRENT/YEARS ATTENDED
PRIORITY 2 – IS THE APPLICANT A SON OF A CURRENT STAFF MEMBER*
- Yes
- No
NAME
PRIORITY 3 – IS YOUR SON THE BROTHER OF A STUDENT WHO PREVIOUSLY ATTENDED THE SCHOOL WITH A MINIMUM OF ONE YEAR IN THE SENIOR SCHOOL?*
- Yes
- No
NAME OF BROTHER and HOUSE GROUP
YEARS ATTENDED
PRIORITY 4 – HOW DOES YOUR SON MEET THESE ASPECTS OF OUR SPECIAL CHARACTER.
- FAITH (SC Key Principle 2) – outline your son’s involvement in the area of Faith
- SERVICE (SC Key Principle 5) – please outline your son’s service work at school or in the Community
- INVOLVEMENT (SC Key Principle 7) – please give details of your son’s extra-curricular activities eg sports (give details of club, grade etc), Performing Arts and Musical instruments (details of tuition and years of lessons) Community Involvement (e.g. Cubs, Scouts etc.). Please complete the separate areas Please list below in the separate areas.
FAITH
SERVICE
INVOLVEMENT*
PRIORITY 5 - SONS OF OLD BOYS / PREVIOUS ASSOCIATION WITH THE SCHOOL*
STUDENT PROFILE FORM
The primary school should complete the Profile Form in support of your son's special character and return it directly to HIBS. Please be aware this is evaluative material and will be destroyed upon the completion of the enrolment process. Please indicate below if a Student Profile form for your son has been submitted to his primary school for completion.
HAS A STUDENT PROFILE BEEN SUBMITTED?*
- YES
- NO

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FAMILY DOCTOR*
PHONE NUMBER*
SURGERY NAME*
DOES THE STUDENT HAVE A MEDICAL CONDITION, DISABILITY OR ALLERGY THE SCHOOL SHOULD BE AWARE OF?*
- Yes
- No
IS YOUR SON UP-TO-DATE WITH HIS VACCINATIONS?*
- Select All
- Diphtheria, tetanus, pertussis, polio and meningitis
- MMR, Meningococcal, Chickenpox
- Tetanus, Diphtheria, whooping cough
Please tick all vaccinations that have been administered
FURTHER DETAILS*
EMERGENCY CONTACT DETAILS

(Relative, friend or neighbour who can be contacted)
NAME*
First Last
RELATIONSHIP TO STUDENT*
TELEPHONE
MOBILE*
FILE
Drop files here or

Accepted file types: pdf, doc, docx, jpg, gif, png.
Please attach a copy of your son’s latest school report, a written character reference, copy of birth certificate, passport size photograph and supporting documentation if applicable.

Files uploaded must be one of the following file types: .pdf, .doc, .docx., .jpg, .gif or .png
Number
Name
This field is for validation purposes and should be left unchanged.

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European
New Zealand European
British
Celtic
Channel Islander
Cornish
English
Gaelic
Irish
Manx
Orkney Islander
Scottish
Shetland Islander
Welsh
British
Dutch
Greek
Polish
South Slav
Croatian
Dalmatian
Macedonian
Serbian
Slovenian
Bosnian
South Slav
Italian
German
Australian
Albanian
Armenian
Austrian
Belgian
Bulgarian
Belorussian
Corsican
Cypriot
Czech
Danish
Estonian
Finnish
Flemish
French
Greenlander
Hungarian
Icelandic
Latvian
Lithuanian
Maltese
Norwegian
Portuguese
Romanian
Gypsy
Russian
Sardinian
Slavic
Slovak
Spanish
Swedish
Swiss
Ukrainian
American
Burgher
Canadian
Falkland Islander
New Caledonian
South African
Afrikaner
Zimbabwean
European nec
Maori
Pacific Peoples
Samoan
Cook Islands Maori
Aitutaki Islander
Atiu Islander
Mangaia Islander
Manihiki Islander
Mauke Islander
Mitiaro Islander
Palmerston Islander
Penrhyn Islander
Pukapuka Islander
Rakahanga Islander
Rarotongan
Tongan
Niuean
Tokelauan
Fijian
Admiralty Islander
Australian Aboriginal
Austral Islander
Palau Islander
Bismark Archipelagoan
Bougainvillean
Caroline Islander
Easter Islander
Gambier Islander
Guadalcanalian
Chamorro
Hawaiian
Kanak
Kiribati
Malaitian
Manus Islander
Marianas Islander
Marquesas Islander
Marshall Islander
Nauruan
New Britain Islander
New Georgian
New Irelander
Banaban
Papua New Guinean
Phoenix Islander
Pitcairn Islander
Rotuman
Santa Cruz Islander
Tahitian
Solomon Islander
Torres Strait Islander
Tuamotu Islander
Tuvaluan
Ni Vanuatu
Wake Islander
Wallis Islander
Yap Islander
Pacific Peoples
Asian
Southeast Asian
Filipino
Cambodian
Vietnamese
Burmese
Indonesian
Laotian
Malay
Thai
Southeast Asian
Chinese
Hong Kong Chinese
Cambodian Chinese
Malaysian Chinese
Singaporean Chinese
Vietnamese Chinese
Taiwanese
Chinese
Indian
Bengali
Fijian Indian
Gujarati
Indian Tamil
Punjabi
Sikh
Anglo Indian
Indian
Sri Lankan
Sinhalese
Sri Lankan Tamil
Sri Lankan
Japanese
Korean
Afghani
Bangladeshi
Nepalese
Pakistani
Tibetan
Eurasian
Asian
Middle Eastern
Algerian
Arab
Assyrian
Egyptian
Iranian/Persian
Iraqi
Israeli/Jewish
Jordanian
Kurd
Lebanese
Libyan
Moroccan
Omani
Palestinian
Syrian
Tunisian
Turkish
Yemeni
Middle Eastern
Latin American
Argentinian
Bolivian
Brazilian
Chilean
Colombian
Costa Rican
Latin American Creole
Ecuadorian
Guatemalan
Guyanese
Honduran
Malvinian
Mexican
Nicaraguan
Panamanian
Paraguayan
Peruvian
Puerto Rican
Uruguayan
Venezuelan
Latin American
African
United States Creole
Jamaican
Kenyan
Nigerian
African American
Ugandan
West Indian
Somali
Eritrean
Ethiopian
Ghanaian
African
Central American Indian
Inuit
North American Indian
South American Indian
Mauritian
Seychellois
South African Coloured
New Zealander
Other Ethnicity
Don't Know
Not Stated

Te Tai Tokerau/Tamaki-makaurau (Northland/Auckland) Region, not further defined
Te Aupouri
Ngati Kahu
Ngati Kuri
Ngapuhi
Ngapuhi ki Whaingaroa-Ngati Kahu ki Whaingaroa
Te Rarawa
Ngai Takoto
Ngati Wai
Ngati Whatua
Te Kawerau
Te Uri-o-Hau
Te Roroa
Hauraki (Coromandel) Region, not further defined
Ngati Hako
Ngati Hei
Ngati Maru (Marutuahu)
Ngati Paoa
Patukirikiri
Ngati Porou ki Harataunga ki Mataora
Ngati Pukenga ki Waiau
Ngati Rahiri Tumutumu
Ngai Tai (Hauraki)
Ngati Tamatera
Ngati Tara Tokanui
Ngati Whanaunga
Waikato/Te Rohe Potae (Waikato/King Country) Region, not further defined
Ngati Haua (Waikato)
Ngati Maniapoto
Ngati Raukawa (Waikato)
Waikato
Te Arawa/Taupo (Rotorua/Taupo) Region, not further defined
Ngati Pikiao (Te Arawa)
Ngati Rangiteaorere (Te Arawa)
Ngati Rangitihi (Te Arawa)
Ngati Rangiwewehi (Te Arawa)
Tapuika (Te Arawa)
Tarawhai (Te Arawa)
Tuhourangi (Te Arawa)
Uenuku-Kopako (Te Arawa)
Waitaha (Te Arawa)
Ngati Whakaue (Te Arawa)
Ngati Tuwharetoa
Ngati Tahu-Ngati Whaoa (Te Arawa)
Tauranga Moana/Mataatua (Bay of Plenty) Region, not further defined
Ngati Pukenga
Ngaiterangi
Ngati Ranginui
Ngati Awa
Ngati Manawa
Ngai Tai (Tauranga Moana/Mataatua)
Tuhoe
Whakatohea
Te Whanau-a-Apanui
Ngati Whare
Te Tai Rawhiti (East Coast) Region, not further defined
Ngati Porou
Te Aitanga-a-Mahaki
Rongowhakaata
Ngai Tamanuhiri
Te Matau-a-Maui/Wairarapa (Hawke's Bay/Wairarapa) Region, not further defined
Rongomaiwahine (Te Mahia)
Ngati Kahungunu ki Te Wairoa
Ngati Kahungunu ki Heretaunga
Ngati Kahungunu ki Wairarapa
Ngati Kahungunu, region unspecified
Rangitane (Te Matau-a-Maui/Hawke's Bay/Wairarapa)
Ngati Kahungunu ki Te Whanganui-a-Orotu
Ngati Kahungunu ki Tamatea
Ngati Kahungunu ki Tamakinui a Rua
Ngati Pahauwera
Ngati Rakaipaaka
Taranaki (Taranaki) Region, not further defined
Te Atiawa (Taranaki)
Ngati Maru (Taranaki)
Ngati Mutunga (Taranaki)
Nga Rauru
Nga Ruahine
Ngati Ruanui
Ngati Tama (Taranaki)
Taranaki
Tangahoe
Pakakohi
Whanganui/Rangitikei (Wanganui/Rangitikei) Region, not further defined
Ngati Apa (Rangitikei)
Te Ati Haunui-a-Paparangi
Ngati Haua (Taumarunui)
Ngati Hauiti
Manawatu/Horowhenua/Te Whanganui-a-Tara(Manawatu/Horowhenua/Wellington)Regionnfd
Te Atiawa (Te Whanganui-a-Tara/Wellington)
Muaupoko
Rangitane (Manawatu)
Ngati Raukawa (Horowhenua/Manawatu)
Ngati Toarangatira (Te Whanganui-a-Tara/Wellington)
Te Atiawa ki Whakarongotai
Ngati Tama ki Te Upoko o Te Ika (Te Whanganui-a-Tara/Wellington)
Ngati Kauwhata [new in 2011, to align with NZ Stats]
Te Waipounamu/Wharekauri (South Island/Chatham Islands) Region, nfd
Te Atiawa (Te Waipounamu/South Island)
Ngati Koata
Ngati Kuia
Kati Mamoe
Moriori
Ngati Mutunga (Wharekauri/Chatham Islands)
Rangitane (Te Waipounamu/South Island)
Ngati Rarua
Ngai Tahu / Kai Tahu
Ngati Tama (Te Waipounamu/South Island)
Ngati Toarangatira (Te Waipounamu/South Island)
Waitaha (Te Waipounamu/South Island)
Ngati Apa ki Te Ra To
Tainui
Te Arawa
Takitimu
Aotea
Mataatua
Mahuru
Mamari
Ngatokimatawhaorua
Nukutere
Tokomaru
Kurahaupo
Muriwhenua
Hauraki / Pare Hauraki
Turanganui a Kiwa
Te Tauihu o Te Waka a Maui
Tauranga Moana
Horouta
Te Atiawa, region unspecified
Ngati Haua, region unspecified
Ngati Maru, region unspecified
Ngati Mutunga, region unspecified
Rangitane, region unspecified
Ngati Raukawa, region unspecified
Ngati Tama, region unspecified
Ngati Toa, region unspecified
Waitaha, region unspecified
Ngati Apa, area unspecified
Ngai Tai, area unspecified [not in NZ Stats, but we keep it as is filling a need]
Hapu Affiliated to More Than One Iwi
Not Stated

SUPPORT OF THE SPECIAL CHARACTER AT HIBS

PRIORITY 4 – HOW DOES YOUR SON MEET THESE ASPECTS OF OUR SPECIAL CHARACTER.