Leamington School
Leamington School International Enrolment
Please complete this form with as much detail as possible. Thank you.
1
Student Details
2
Visa and Health Insurance Details
3
Caregiver Details while in NZ
4
Parent Details
5
Emergency Contact Details
6
Miscellaneous Information
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Details about your child
Child's Legal Surname
*
Child's Legal First Names (include middle names please)
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Child's Preferred First Name
Child's Preferred Surname
Child's Physical Address in NZ
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Child's Date of Birth
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DD
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MM
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YYYY
Gender
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Boy
Girl
Languages Spoken at home
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English
Maori
Samoan
Hindi
Mandarian Chinese
French
German
Tongan
Spanish
Fijian
Afrikaans
Dutch
Other
Country of birth
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Main language spoken
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Ability to communicate in Engilsh
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Cannot communicate in English
Understands simple commands and instructions
Can have a basic conversation in English
Has a good grasp of the english language
Does your student have any special needs - i.e. physical, sensory, cognitive, psychosocial, or behavioural difficulty, or a combination of these, and that difficulty or those difficulties affect his or her ability to participate, learn, and achieve; or
requires the provision of adapted programmes or learning environments, or specialised equipment or materials to support him or her to access the curriculum, participate, learn, and achieve? If yes, please specify. (Failure to disclose this may result in the offer of enrolment cancelled.)
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Child's Home Phone Number in NZ
Date expected to start at Leamington School
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DD
/
MM
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YYYY
Date expected to finish at Leamington School
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DD
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MM
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YYYY
1
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7
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