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Young Men Taking Their Place in the World

 

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1 Student Details
2 Caregiver details
3 EMERGENCY CONTACTS
4 HEALTH & Learning INFORMATION
5 References
6 DOCUMENTATION
Nelson College Domestic BOARDING Enrolment
Student Details
Legal First Name
Middle Names
Legal Surname
Preferred First Name(if different)
Preferred Surname(if different)
Date of Birth
Current / Previous school
Term or date
Name of Sibling(s) currently at Nelson College(if any)
Preferred Boarding House
Address of Student
Note: if student resides between two addresses please ALSO complete secondary caregiver details on the next page.
Street Address
Rural Delivery
Suburb
City
ZIP / Postal Code
PRIMARY CAREGIVERS (as at student's address)
Primary Caregiver
Full Name
Occupation
Home Telephone No.
Employer
Mobile
Business Telephone No.
Primary Caregiver
Full Name
Occupation
Home Telephone No.
Employer
Mobile
Business Telephone No.
Mail to whom - salutation for primary caregivereg: Mr J & Mrs S Jones, (for official letters and invoices)
Primary caregivers postal address - if different from studentStreet address
Rural Delivery
Suburb
City
ZIP / Postal Code
SECONDARY CAREGIVERS (secondary residence - if applicable)
Full Name
Occupation
Home Telephone No.
Employer
Mobile
Business Telephone No.
Full Name
Occupation
Home Telephone No.
Employer
Mobile
Business Telephone No.
Secondary caregivers AddressFull postal address
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SEPARATED PARENTS ONLY
If parents are separated at whose address does the student normally reside?
Payment of accounts - please indicate who will be responsible for the payment of school accounts
Legal AccessName of any person who does NOT have legal access to your son (Court Order will be required)
Emergency Contact
Note the Emergency contacts must be different from the caregiver contacts.
Full Name
Home Telephone No.
Mobile
Health Information
The ongoing health and wellbeing of your son is the reason we require the following information. Please answer all questions in full. All information on this form is for use by Management, health professionals and counsellors only
Family Doctor
Dentist
Consent to administer Paracetamol if required
Consent to administer Ibuprofen if required
Has your son had any of the following illnesses?(please mark if YES to any of the following)
Medical Conditions(please mark if YES to the following questions)
Please give details if you have answered YES to any of the Medical Conditions above or wish to add any further details
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Mental Health(Please mark if YES to the following questions)
Please give details if you have answered YES to any of the Mental Health questions
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Immunisation / Vaccination Information
Learning Support Details (if applicable)
Has your son(please mark if YES to the following questions)
Please give details if you have answered YES to any of the Learning Support questions
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References - please nominate two non-family members who can be contacted for confidential references:
Referees name
Home phone number
Work phone number
Referees name
Home phone number
Work phone number
Please complete a short statement by the applicant on why he would like to come to Nelson College.
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How did you hear about Nelson College?
Documents to be provided
Proof of Domestic Statusie: Photocopy of student's NZ Birth Cert., NZ Passport, NZ Citizen Cert., Australian Passport, or Residency Visa
Upload
Latest school report
Upload
Copy of Immunisation recordsPlunket book or generated from your doctor
Upload
Court OrderVerification for legal access if applicable
upload
Learning SupportRelevant educational or medical professional reports
Upload
Enrolment Terms & Condtions

Policies relating to this enrolment are available on the college website. For further clarification of any of the policies contact the Headmaster.

View Enrolment Terms & Conditions

• I/we have read and understood the terms and conditions of the Nelson College Uniform Policy and agree that my son will abide by this policy.
• I/we declare that the information supplied is true and correct and agree to observe the following conditions of enrolment.
• For the purposes of the Privacy Act 1993, I hereby acknowledge and understand the terms and conditions.
Non-refundable application fee of $100 must accompany this application form. Online payment to account 03 0703 0365073 03, using your son’s name and ‘Boarding Enrolment’ as reference. Note: Payment of this fee does not commit the College to accepting the applying student into Boarding
Full name(s) of Parent/Legal Guardian
Relationship to student
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