Application to Enrol - Distance Learning

Please complete the online application below, or click here for the printable version.

Application for Enrollment - Distance Learning

Student's First Name:

Student's Last Name:

Student's preferred name:

Address & Postcode:

Postal Address (if different):

Home Phone:

Mobile Phone:

Birth date:

Age:

Ethnicity:

Iwi:

Male/Female:

Present Year Level:

Last early childhood centre or school attended:

Father's name:

Occupation:

Email:

Personal Mobile:

Address & Postcode:

Mother's name:

Occupation:

Email:

Personal Mobile:

Address & Postcode:

Person responsible for student at home:

Previous experience using A.C.E Pace's (Yes/No)

Father, Christian Y/N

Mother, Christian Y/N

When:

Level:

Church Attended:

Does student have special needs / medical conditions:

Please indicate general academic acheivement of student's previous work:

Has your child ever been suspended, dismissed, or refused enrollment to any other school:

Reason for choosing Otamatea Christian School's Distance Learning Programme:

I agree that if my child is admitted for enrolment to Otamatea Christian School’s Distance Learning Programme, I will insist that he / She complies to the programme, discipline, and other requirements of the school.

Signed Caregiver 1 (Father)

Date

Signed Caregiver 2 (Mother)

Date

Where did you hear about OCS Distance learning

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