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: Required
    Date of birth: Required
    Place of birth: Required
    Gender: Required
    Home address (No. & Street): Required
    Home address (Suburb): Required
    Who does the child live with? Required
    Names of siblings at NMC: Required
    Entry date requested: Required
    Present or last school attended: Required
    Ethnic Group: ** Required
    **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: Required
    Full name: Required
    Home address: Required
    Email address: Required
    Home phone number: Required
    Work phone number: Required
    Mobile phone number: Required
    Occupation and industry: Required
    Work Skills: Required
    Does this parent have legal rights to the child? Required
    Does this parent have legal access to personal information about the child? Required
     
    Second Parent's Details
    Relationship to child:
    Full name:
    Home address (if different from child):
    Email address:
    Home phone number:
    Work phone number:
    Mobile 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:
    Mobile 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?
     
    Emergency Contact
    Relationship to child: Required
    Full name: Required
    Home phone number: Required
    Work phone number: Required
    Mobile phone number: Required
     
    Family
    Brother/Sister (Put "none" if no siblings): Required
    Age (Put "0" if no siblings): Required
    Brother/Sister:

    Age:
    Brother/Sister:
    Age:
    Brother/Sister:
    Age:
     
    Child's Health Details
    Physician name: Required
    Physician address: Required
    Physician phone number: Required
    Vaccinations: Required
    Does the child have any medical conditions the school should be aware of? Required
    Allergies? Required
    Vision? Required
    Hearing? Required
    Medication? Required
    Other? Required
    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? Required