SDC Enrolment Form
ID:0 | 10/05/2024 |
Recipient: Guest
Originator: Guest
1 New Enrolment
New Enrolment
2 Caregiver Details
Caregiver Details
3 Medical Information
Medical Information
4 Additional Information
Additional Information
5 Upload Documents
Upload Documents
6 Conditions
Conditions
* Mandatory fields | 
Print
1
New Enrolment

Please complete all fields in lower case with a Capital for the first letter e.g Mary Smith not MARY SMITH 

When you have completed the application, click the Save & Submit  button at the bottom of the Conditions screen, otherwise use the Temporary Save  button to save where you are up to and complete the form later. 
1
Guest Info

Full Name of person filling out this application *

Email Address *
1
Student Details

First Name *

Surname *

Known as (if different from above)
Legal Surname (if different from above)

Nationality/Citizenship *

Country of Birth *

Date of Birth *

Home Address *

Current school, select Overseas if not in NZ *

The student's year level when starting at St Dominic's College *

House request (optional) - we'll do our best but it is not always possible to be placed in the requested house.



1
Ethnicity/Language

Student's ethnicity *

Ethnicity 2
Ethnicity 3

If NZ Maori, choose up to 3 Iwi/Hapu
Iwi 2
Iwi 3

Main language spoken at home? *

Other language
Other language
1
Religion

Religion *

If not Catholic, state denomination/religion

Student Baptised *

Place and Date of Baptism

Please tick the Sacraments your daughter has received
Do you wish your daughter to participate in the St Dominic's College Sacramental programme?  For more information,  click here. *

Upload certificates here if you have them available:
2
Caregiver 1

Title *

First Name *

Surname *

Relationship to student *

Mobile Phone
Home Phone

Email Address *



Occupation *

Work Phone

Employer
Employer Address

Is this caregiver a past student of St Dominic's College? *

Does the student live with this caregiver? *

Home Address (if different from student's)
If living arrangements are shared, please provide details:

Tick all correspondence required for this caregiver: *







Willingness to support the College through:
(please tick all that apply)

 




Details:  (from question above)
2
Caregiver 2

Title
First Name

Surname
Relationship to student

Mobile Phone
Home Phone

Email Address


Occupation
Work Phone

Employer
Employer Address

Is this caregiver a past student of St Dominic's College?
Does the student live with this caregiver?

Home Address (if different from student's)
If living arrangements are shared, please provide details:

Tick all correspondence required for this caregiver:

Willingness to support the College through:
(please tick all that apply)

 




Details:   (see question above)
2
Caregiver 3

Title
First Name

Surname
Relationship to Student

Mobile Phone
Home Phone

Email Address


Occupation
Work Phone

Employer
Employer Address

Is this caregiver a past student of St Dominic's College?
Does the student live with this caregiver?

Home Address (if different from student's)
If living arrangements are shared, please provide details:

Tick all correspondence required for this caregiver:

Willingness to support the College through:
(please tick all that apply)

 




Details:  (see above)
3
Emergency Contact

The emergency contact person cannot be the student's parent/caregiver.  If the need should arise and parents/caregivers are not available, the emergency contact must be available to be contacted at short notice and/or collect the student.
3
Emergency Contact Details

First Name *

Family Name *

Relationship to Student (not parent/caregiver) *

Mobile Phone
Home Phone
Work Phone
3
Medical Information

Doctor or Medical Centre Name
Phone

Please indicate if the student suffers from:
Anaphylaxis?
Asthma?

Diabetes?
Epilepsy?

Does the student carry an inhaler?


Paracetamol Allowed? *

Antihistamine Allowed? *

Please list any allergies the student has:
Any other health matters which the school should be aware of:
4
Additional Information

What strengths, abilities and interests does the student have that you would like us to know about?

Academic & Leadership

Sports Played

Cultural/Artistic Interests (ie Art, Dance, Drama, Music)

Hobbies

Specific Learning Needs 
Does the student currently have or require extra support with classroom work or school behaviour?
4
Family Connections

Any family members currently or previously enrolled at St Dominic's College?
Please include full name, relationship to the student, and house (if known):

Any family connections with the Dominican Sisters or with other Catholic schools?

Does the student have younger school age siblings?
Please include name, age and current school of siblings:
5
DOCUMENTS

This application will not be accepted if the following documentation is not attached.  If you need a copy of the Preference of Enrolment Certificate or the Attendance Dues Agreement form, they can be downloaded from the Enrolment webpage 

Copy of Birth Certificate or Passport *

Copy of most recent school report *

Copy of Permanent Residency Permit or Student Visa (if applicable)

Preference of Enrolment Certificate (must be signed by your parish priest or another agent of the Bishop)

Attendance Dues Agreement *

Passport-sized photo of student

Any other supporting documents?
6
Conditions of Enrolment

I/We, the undersigned, accept as conditions of enrolment that:

I/we will support and encourage the named student in the practice of the special character of the College and her full participation in the Catholic life of the College, specifically Religious Education field trips, classes, retreats, and full-school liturgies.
  *


I/we will ensure that the policies and rules, as laid down by the College and Board of Trustees, are observed.
  *

I/we will ensure that the named student will at all times abide by the uniform requirements of the College and will adhere to the Code of Conduct.
  *

All students are expected to have a device at school each day. *

Attendance Dues, collected by the College on behalf of the Propretor, are a compulsory charge.  Full information on parent financial contributions is available here. *

Enrolment is subject to availability of places within the prescribed allocation; and that the final decision on whether a student meets the enrolment criteria and is therefore able to be accepted as a student at St Dominic's Catholic College, rests with the Principal.  The Principal's decision is final and no correspondence will be entered into.
  *

The information about the named student that is related to the functions of the school Proprietor may be disclosed to the Proprietor or the Proprietor's agents.
  *

PRIVACY ACT 1993

The personal information you have supplied on this enrolment form is being collected to assist us in understanding and educating the named student.  We may pass this information on to other educational professionals but only for these same purposes.  Under the Privacy Act 1993, you have the right to access any personal information we hold on this student.  Should we wish to release details held for other than the purposes stated, we will consult you under the provisions of the Act.

DECLARATION: I /we confirm that the information in this application is true and correct in every way:
  *


Name: *

Date: *

Name:

Date:

If you have completed the application, click the Save & Submit  button at the bottom of the screen, otherwise use the Temporary Save  button to save where you are up to and complete the form later. 
6
[OFFICE USE ONLY]

Pref Code:


Interviewer

7
Next Temporary Save
Save & Submit Close

eForms Workflow statistics  
   Refresh
Please select the student associated with this eForm from the list
  Next  
Do you want to continue the partially filled eForm from the last session?


Yes, continue from where I leftNo, I want to fill a new eForm

Warning: Saving New eForm will destroy any partially filled old eForm!