MANGAROA SCHOOL — ENROLMENT FORM

New Entrants: Please supply a copy of your child's birth certificate, or if born overseas, visa documentation. Immunisation records required. Proof of address within school zone required.

1. Student Information
Male Female Other
Residency
NZ Citizen Permanent Resident Student Visa Other Visa
Address & Zone
YES NO
2. Living Arrangements
Mother Father Both Shared Caregiver
of
YES NO
MANGAROA SCHOOL — ENROLMENT FORM (continued)
3. Guardian Information
👩 Mother / Guardian 1
👨 Father / Guardian 2
4. Emergency Contacts
Alternative Emergency Contacts — authorised to take responsibility for my child
Civil Defence Emergency Contacts — authorised to collect my child in a civil emergency
MANGAROA SCHOOL — ENROLMENT FORM (continued)
5. Health Information
YES NO
Allergies & Medication
Asthma Inhaler Diabetes Bee/Wasp Allergy Other
YES NO
Fully Immunised Partially Immunised Unimmunised Other:
Please attach your child's Immunisation Certificate — this is a legal requirement.
6. Early Childhood Education & Previous Schooling
Required by the Ministry of Education. Enter hours/week for up to three simultaneous services. If your child changed service within the last 6 months, complete the last service only.
Service Type Service 1 (hrs/wk) Service 2 (hrs/wk) Service 3 (hrs/wk)
1. Kōhanga Reo
2. Playcentre
3. Kindergarten / Education & Care Centre
4. Home Based Service
5. Playgroup
6. The Correspondence School – Te Aho o Te Kura Pounamu
Or — tick appropriate box:
Attended, but only outside New Zealand Attended, but don't know what type of service Did not attend Unable to establish if attended or not
Yes, regularly attended for the last ______ year(s) Not regularly — only occasionally with no ongoing schedule No, did not attend Early Childhood Education
YES NO
MANGAROA SCHOOL — ENROLMENT FORM (continued)
7. Permissions & Consents
I/We consent:
1. In the event of an accident or sudden illness, I/we authorise the staff of Mangaroa School to obtain such medical assistance as may be necessary when I/we cannot be contacted. I/we agree to meet any cost incurred for the treatment or transportation of my child to receive medical attention.
YES NO
2. I/we give permission for staff at Mangaroa School to administer pain relief or other medication as listed on this child's records, if required.
YES NO
3. I/we give permission for my child to undergo vision and hearing testing.
YES NO
4. I/we give permission for my child to be seen by a School Health Professional or Dental Nurse.
YES NO
5. I/We give consent for my child to be given access at school to computers, the Internet and other communication technologies.
YES NO
6. I/we give permission for my child's photo to be taken whilst participating in school activities. Photos may be used for promotional purposes in the school's newsletters, website and school media apps.
YES NO
8. Declaration & Consent (Privacy Act 1993)

The Education Act gives a guarantee to students who live in the home zone specified in our Enrolment Scheme. The Board needs to be sure that an in zone address is genuine, because it is required to manage the enrolment scheme for the benefit of local students. The address given at the time of application for enrolment must be the student’s usual place of residence when the child starts at Mangaroa School. This means that if you currently live at an in-zone address but move to an out-of-zone address before your child’s first day of attendance, your child will not be entitled to enrol at the school.

Declaration: I/We confirm that the information contained in this enrolment application is true and correct in every respect. The address provided will be the usual place of residence when my/our child starts at Mangaroa School, and I/we intend to live at this address permanently. I/We will advise the school of any subsequent change of address, either prior to enrolment or during my child's attendance at the school.

Consent under the Privacy Act 1993: I understand that the information on this form forms part of the essential records the school holds on my child. These records may be viewed on request. I approve the forwarding of information when my child transfers to another school, and to a potential intermediate or secondary school. I understand the school will take action on my behalf in case of sudden illness or injury, and I agree to abide by school policies. I will advise the school of any changes in my child's personal details during his/her attendance at Mangaroa School.
YES NO
🔒 Office Use Only
Birth Certificate Immunisation Certificate Proof of Address Pre-Enrol

Mangaroa School

Enrolment Zone Information

9. Enrolment Zone Information

Mangaroa School is a popular school and the Board of Trustees is limited in the number of places it is able to offer students as a consequence of operating an enrolment scheme. All children wishing to be considered for enrolment should complete an enrolment form and lodge it with the school office as early as possible. This applies to children living in-zone and out of zone.

The order of priority for students is as follows.

Home Zone Enrolments

All students who live within the home zone described below shall be entitled to enrol at the school. Proof of residence within the home zone is required.

Out of Zone Enrolments

Twice a year the Board will determine the number of places likely to be available in the following year for enrolment of students who live outside the home zone.

The Board will operate two enrolment periods: January – June and July – December.

Applications for out of zone enrolment will be processed in the following Ministry of Education defined order of priority:

  • First Priority — Not applicable at Mangaroa School, as the school does not run a special programme approved by the Ministry of Education.
  • Second Priority — Applicants who are siblings of current students.
  • Third Priority — Applicants who are siblings of former students.
  • Fourth Priority — Applicants who are children of board employees.
  • Fifth Priority — All other applicants.

If there are more applicants in the second, third, fourth or fifth priority groups than there are places available, selection within the priority group will be by ballot. Parents will be informed of the date of any ballot.

Applicants seeking second or third priority status will be required to give proof of a sibling relationship.

If the number of applicants exceeds the places available, students unsuccessful after the ballot will be placed on a priority waiting list, should places later become available.

The Mangaroa School Home Zone

The Mangaroa School home zone is:

  • To the north – the intersection of Parkes Line Road and Maymorn Road
  • To the west – the top of Mangaroa Hill Road and the top of Wallaceville Road
  • To the south – Johnson’s Road, Whitemans Valley
Important Information About Your Address

The address given at the time of application for enrolment must be the student’s usual place of residence when the school is open for instruction. This means if you currently live at an in-zone address but move to an out-of-zone address before your child’s first day of attendance at the school, your child will not be entitled to enrol at the school of right.

The Ministry of Education has advised that parents should be warned of the possible consequences of deliberately attempting to gain unfair priority in enrolment by knowingly giving a false address, or making an in-zone living arrangement which is intended to be only temporary, for example:

  • Renting accommodation in-zone on a short-term basis.
  • Arranging temporary in-zone board with a relative or friend.
  • Using the in-zone address of a relative or friend with no intention of living there on an ongoing basis.

If, after a student has been accepted but before attendance begins, the Board has reasonable grounds for believing that a given in-zone address will not be a genuine ongoing living arrangement, the Board may withdraw any offer of a place made on the basis of that address.

After attendance has begun, if the school learns that a student is no longer living at the in-zone address given at the time of application, or has not lived at that address on an ongoing basis, and has reasonable grounds to believe that a temporary in-zone residence has been used to unfairly gain priority in enrolment, the Board may review the enrolment. Unless the parents/caregivers can give an explanation satisfactory to the Board within 10 days, the Board may annul the enrolment. This course of action is provided for under section 110A of the Education Act 1989.

Please note all in-zone students should have their application for enrolment in by the closing date to guarantee an immediate place.

A copy of this information will be given to all parents applying to enrol their child. A signed copy will be attached to each application for enrolment. Please note that by signing this information you are indicating that you understand the zoning status and are making a true declaration of your child’s in-zone/out-of-zone status.