Expression of Interest

If you prefer you may complete a hardcopy version of this form. Please click here for a printable version.

Please send your completed forms to: Nova Montessori School, 53 Owles Terrace, New Brighton, Christchurch

* Please complete all fields where applicable. All fields marked with an asterisk(*) are compulsory.

   
Child's Details  
Child's full name: *
Date of birth: *
Place of birth: *
Gender: *
Home address (No. & Street): *
Home address (Suburb): *
Who does the child live with? *
Names of siblings at NMC: *
Entry date requested: *
Present or last school attended: *
Ethnic Group **
**As required by Ministry of Education. Please state Pakeha/European, Maori, Pacific Islander, etc.  
   
Foreign Students Only  
Are you an NZ permanent resident?
Passport number:
Visa status:
NZ entry date:
   
First Parent's Details  
Relationship to child: *
Full name: *
Home address (if different from child): *
Email address: *
Home phone number: *
Work phone number: *
Cell phone number: *
Occupation and industry: *
Work Skills: *
Does this parent have legal rights to the child? *
Does this parent have legal access to personal information about the child? *
   
Second Parent's Details  
Relationship to child:
Full name:
Home address (if different from child):
Email address:
Home phone number:
Work phone number:
Cell phone number:
Occupation and industry:
Work skills:
Does this parent have legal rights to the child?
Does this parent have legal access to personal information about the child?
   
Other Caregiver/Guardian Details  
Relationship to child:
Full name:
Home address (if different from child):
Email address:
Home phone number:
Work phone number:
Cell phone number:
Occupation and industry:
Work skills:
Does this caregiver/guardian have legal rights to the child?
Does this caregiver/guardian have legal access to personal information about the child?
   
Emergency Contact  
Relationship to child:
Full name:
Home phone number:
Work phone number:
Cell phone number:
   
Family  
Brother/Sister (Put "none" if no siblings): *
Age (Put "0" if no siblings): *
Brother/Sister:
Age:
Brother/Sister:
Age:
Brother/Sister:
Age:
   
   
Child's Health Details  
Physician name: *
Physician address: *
Physician phone number: *
Vaccinations: *
Does the child have any medical conditions the school should be aware of?* *
Allergies? *
Vision? *
Hearing? *
Medication? *
Other? *
Please tell us any additional information that might impact on your child's interaction within the school community (beg. behavioural, social, high needs, other medical issues): *
   
Other  
How did you hear about Nova Montessori School? *