Online Ballot Form

Out of Zone Applications

APPLICATION FOR BALLOT

(This is not an Enrolment Form)

Details of Parents / Caregivers
Name*
Prefix First Last
Relationship to child*
Home Address*
Street Address Address Line 2 City Suburb Post Code Country
Email*
Phone (home)*
Phone (work)*
Mobile Phone*
Details of Children
Name of Child (1)*
First Last
Gender (1)*
- Male
- Female
Date of Birth (1)*
DD slash MM slash YYYY
Age (1)*
2021 Class year (1)*
Present School or Pre School (1)*
Name of Child (2)
First Last
Optional, if no more than 1 child, please leave it blank.
Gender (2)*
- Male
- Female
Date of Birth (2)*
DD slash MM slash YYYY
Age (2)*
2021 Class year (2)*
Present School or Pre School (2)*
Name of Child (3)
First Last
Optional, if no more than 2 child, please leave it blank.
Gender (3)*
- Male
- Female
Date of Birth (3)*
DD slash MM slash YYYY
Age (3)*
2021 Class year (3)*
Present School or Pre School (3)*
Are you wanting to enrol in:*
- Mainstream Education
- Te Moana Nui a Kiwa (Te Reo)
Do you have a child attending Homai School?
Names of brothers, sisters who previously attended the school.
Name of parent (if any) who is currently employed by the school
Names of parent (if any) who was a pupil of this school
Does your child have any special learning needs?
Does your child have any current/past interventions and support from Ministry of Education, or any other agencies?
Consent*
I, declare that the information given above is accurate. I acknowledge that any enrolment based on false information may be annulled. I also acknowledge that I have a right of appeal against non-acceptance to the Secretary of Education whose decision will be binding on both parties.
Please write your full name as form of digital signature*
Date*
DD slash MM slash YYYY
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APPLICATION FOR BALLOT

Details of Parents / Caregivers

Details of Children

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