Don Buck Primary School welcomes new students and families.

To take a tour of our school, meet the team, and learn more about who we are and what we do please make an appointment at the office or call us on 09 833 6005.

Enrolment Process

Please complete the online form below, or get a hard copy from the school office. Then call or email us to arrange a meeting to provide documentation, and we can answer any questions you might have.

Don Buck School Enrolment Form

"*" indicates required fields

In addition to this form, the following documents are required by the school office:

• Birth Certificate if born in NZ or Passport if born overseas
• Immunisation Certificate
• 2x Proof of Residence
• Any documentation pertaining to custody restrictions

Is this an in zone or out of zone enrolment application?

In Zone

Out of Zone

Please check the zoning information page if you are not sure.

Student Details

Name*

First Last

Preferred Name (if applicable)

First Last

Date of birth*

Gender*

Male

Female

Other

Student's gender*

Physical Address*

Street Address Address Line 2 City ZIP / Postal Code

Parent / Caregiver 1 Details

Name*

First Last

Title*

Mrs

Ms

Miss

Mr

Legal guardian?*

Yes

No

Relationship to child*

Mother

Father

Aunt

Uncle

Grandmother

Grandfather

Other

Please specify relationship*

Address (if different to the student's above)

Street Address Address Line 2 City ZIP / Postal Code

Email*

Mobile phone*

Parent / Caregiver 2 Details

Name

First Last

Title

Mrs

Ms

Miss

Mr

Legal guardian?

Yes

No

Relationship to child

Mother

Father

Aunt

Uncle

Grandmother

Grandfather

Other

Please specify relationship

Address (if different to the student's above)

Street Address Address Line 2 City ZIP / Postal Code

Email

Mobile phone

Siblings

Names of any siblings currently at Don Buck School

Emergency Contact Details

Emergency Contact 1

Name*

First Last

Phone*

Relationship to child*

Emergency Contact 2

Name*

First Last

Phone*

Relationship to child*

Ethnicity Information

ETHNIC GROUP/S: Please tick appropriate boxes (up to three)

Ethnicity*

Māori

NZ European

Samoan

Tongan

Cook Island Maori

Other

You responded Māori, please indicate your Iwi / Hapu*

You responded 'Other', please specify*

Country of birth (if other than New Zealand)

Home language*

If you have moved to New Zealand from overseas, please answer the following:

Time lived in New Zealand (e.g. 1 year 4 months)

Date of arrival in NZ

Mother's country of birth

Father's country of birth

Prior Participation in Early Childhood Education

The below Early Childhood Education information is a requirement as directed from the Ministry of Education.

Was ECE regularly attended?*

Yes

Not regularly

Only occasionally or with no ongoing schedule

No, did not attend ECE

How many years did the child attend ECE for?*

Previous School / Kindergarten*

Year level at previous School / Kindergarten*

Custody / Access Restrictions

Please provide the necessary documentation to the school office.

Briefly outline any issues or concerns that you feel would be helpful for us to be aware of:

Medical Information

I consent to my child’s vision and hearing being tested*

Yes

No

Medication: Please let us know of any medication requirements your child may have at school:

Does your child have any special dietary requirements or allergies?

Is it okay for the school to administer PANADOL tablets or liquid pamol if necessary?*

Yes

No

Family Doctor's Name*

Family Doctor's Phone Number*

Learning / Behaviour Needs

Please state any special learning, ability or behaviour needs your child may have:

Parent / Caregiver Agreement

Parent / Caregiver Agreement

I have completed all relevant sections of the enrolment form and the information supplied is correct.

I have supplied copies of documentation where applicable (i.e. Birth Certificate, Passport, Immunisation Certificate, proof of address)

My child will be attending school regularly.

My child will abide by the School Policies.

My child will wear the correct Don Buck Primary School uniform.

I give permission for my child’s records to be obtained from their previous school.

I understand and accept that school records containing information about my child may be shared with education and/or health officials, and will be forwarded on to the next school my child attends.

Along with all staff at Don Buck School, our Community Constable, our Public Health Nurse and our SWiS (Social Worker in Schools), will be involved in your child’s care and well being while they attend our school. If you do not wish your child/ren to access this important pastoral caring please indicate

No

I give permission to include my child’s work, image or name in school newsletters, facebook and/or school website*

Yes

No

I give permission for my child to have lunches Monday to Friday*

Yes

No

I give permission for my child to use the internet*

Yes

No

I understand that the information stated on this form is true and correct and agree to be part of the learning process of my child.*

Yes

Parent / Caregiver Signature*

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