Online Enrolment Form

Personal Information

Family names
Given names
If clicking the date on the calender doesn't work, please enter the date in the format of Day/Month/Year

Next Page: Contacts

Parent/Caregiver 1

Name and address of both parents or caregivers (please indicate whom the student lives with)
(if different from above)

Parent/Caregiver 2

If different from above
Please indicated if you wish to receive an electronic copy of the school's newsletter (please make sure you have supplied your email address)

Emergency Contacts

Please list name(s) and addresses of other persons (eg grandparents, close relatives) who could be contacted in case of an emergency of other special need


Name(s) of brothers or sisters who are current students
eg 2 of 3

Next Page: Medical

Medical problems (if any) need to be noted.
Please indicate medication taken
If any medication is to be held at school and administrered by staff, please indicate you have completed the 'Administration of Medication' form

Next Page: Ethinic Origin

A copy of your child's birth certificate should be provided for New Zealand citizens if possible and must be provided for those born overseas some proof of residency must also accompany the application.
Statistical information for Ministry of Education - please tick appropriate ethinic origins of student.

Further Information

I understand that this information will be kept securely and is being collected to allow Kaikorai Valley College to carry out the functions required of it, and that this information may be disclosed to another specified agency only in accordance with Principles 10 and 11 of the Privacy Act 1993. If this application is accepted, the parent/caregiver and student agree to accept the school’s requirements concerning discipline, attendance, uniform and fees. Also I understand that photographs, work produced and other related material may be used from time to time in school publications and for promotional and educational purposes. Payment of Course Costs: The payment of costs associated with running courses is important for the ongoing progress of our students. These may be paid upon invoice or by regular automatic payment into the school bank account. Please contact the Student Office if you wish to set up an automatic payment. If you are paying by Internet banking please include your child’s name in the reference line. Parents/caregivers are asked to pay a voluntary donation towards general school activities but this donation is not mandatory. There will be additional costs for specific school events/activities which will be advised prior to the event/activity. By signing this form I am demonstrating that I am willing to pay costs associated with my child’s education. Contact details on this form are required by law to be forwarded to the Ministry of Social Development. This is so at risk young people can be identified and offered support by organisations contracted to help re-engage young people in education or training when they leave school. The information will not be used for any other purpose. Disclaimer: The Kaikorai Valley College Board of Trustees makes every effort to ensure the grounds and buildings of the college are a safe environment. The Board however accepts no responsibility for any accident or injury that may be sustained by any person or persons, or for damage or loss to property, while on these premises.

Participation Respect Inquiry Diversity Environment

500 Kaikorai Valley Road
Dunedin, New Zealand
Tel +64 3 453 6035
Fax +64 3 453 1602