Application Form

This section for Office Use Only

OOZ Level

Year

Surname:

Tutor Class

Category

Start date

.…../.…../…...

Tauranga Girls’ College 2019 Application for Enrolment Nau Mai Haere Mai Present/Last Year Level: ______________

Date of Birth:

________________________

Family Information *Student’s Legal Surname: *Legal First Names:

_______________________________________

__________________________________ Preferred Name: ________________________

* Legal Surname/Legal First Names = NZ Birth Certificate/Passport/Visa

Student status  Regular NZ student  Exchange student

Bring all documents to your appointment interview.

 Foreign Fee Paying student  overseas student with permanent residency

For immigrants, date entered New Zealand: …../…../…..

Ethnic Origin: (tick those you wish the College to acknowledge)     

Maori  State Iwi: (i) _____________________ (ii) _____________________ (iii)_____________________ NZ European  Chinese  Fijian Indian  Niuean  Pacific Island Other: __________ Samoan  Tokelauan  Tongan Asian (state) _______________  Other (state) _______________________

For speakers of language other than English: What language is spoken at home? ______________________. Is this your daughter’s first language?  Yes  No If No please state what language is: ____________________________ Can your daughter speak other languages  Yes  No. If Yes, which languages? ___________________________

Present/Last School: ____________________________________________________________________________

Telephone:

(Home): _________________________________________________________________________

Address:

Number: ________

Street/Road: _______________________________________________

Suburb/District: _____________________________________________ Post Code: _________ Postal Address (if different): ___________________________________ Post Code: _________

I currently live within the Tauranga Girls’ College school zone

 Yes  No

Caregiver 1: Surname:

_______________________

Mrs/Miss/Ms/Mr

Relationship to student:

___________________

Given name:

___________________________

(Address if different from above)

Telephone:(Home)

_______________________

__________________________________________

(Work)

_______________________

_______________________ Post Code: _________

(Cellphone) _______________________

email: _____________________________________

Caregiver 2: Surname:

_______________________

Mrs/Miss/Ms/Mr

Relationship to student:

___________________

Given name:

___________________________

(Address if different from above)

Telephone:(Home)

_______________________

__________________________________________

(Work)

_______________________

_______________________ Post Code: _________

(Cellphone) _______________________

email: _____________________________________

Name of person(s) for mail to be sent to:

__________________________________________

Address if not given above: _______________________________________________________________________

Secondary Caregiver/Emergency/Alternative Contact (other than Parent/Caregiver – necessary for Health contact): Name:

_____________________________

Telephone: ______________________

Relationship to student:

_____________________________

Cell Phone: ______________________

Personal Details Health Information: Alert to parents: If your daughter has a serious medical condition, please discuss this with the school nurse directly. It is important that we are aware of any life threatening conditions e.g. diabetics, epilepsy, allergies.

In order to provide a safe and healthy environment for your daughter this information will be accessible to the following people with your consent: School Nurse/First Aider, Senior Leaders, Deans, Office Co-ordinator, Emergency Medical Staff, Guidance Counsellors.

The school offers a free, confidential medical service by a General Practitioner (GP).

Doctor’s Name: ________________________ Name of Clinic: _______________________ Phone: ___________ Dentist’s Name: ________________________ Name of Clinic: _______________________ Phone: ___________ Vision/Hearing: Did your daughter have her vision/hearing tested in Yr 7?

Yes/No

Immunisations: Is your daughter immunised? Yes/No Are they up to date? Yes/No Do you have evidence of her vaccination record?

Yes/No

Tetanus: Yes/No



Do you consent to your daughter being given paracetamol at school?

Yes/No (delete as applicable)



Do you consent to your daughter being given ibuprofen at school?

Yes/No (delete as applicable)

Medical conditions: Medication

Medication

Asthma   Anxiety Disorders   Vision Impairment  Bee Sting Allergy   ADD/ADHD   Hearing Impairment  Nut Allergy   Heart Condition   Epi pen  Diabetes   Bleeding disorders   Behavioural problems  Epilepsy   Migraines/Headaches   Special needs  Other: ________________________________________________________________________________________ Allergies: Cause: ___________________________________ Treatment: ________________________________ Before any medication is administered at school, a medication authorisation form must be completed by the parent/caregiver and is kept on file, these are available from the Health Centre.

Present or past association With Tauranga Girls’ College: Name(s) of family (aunt, mother) who attended Tauranga Girls’ College: ___________________________________ Name(s) of sister(s) currently attending Tauranga Girls’ College: __________________________________________ Name(s) of sister(s) who are former students at Tauranga Girls’ College. State their year of leaving: ______________________________________________________________________________________________

Student’s position in family (eg eldest of four): ____________________________________________________ Student’s cell phone (optional):

________________________________________________

Indicate student’s main way of transport to school:



Bus



Bicycle



Car



Walk

The nearest secondary school to your home is: _______________________________________________________

Current participation and /or representation in school sport, cultural and academic activities: Sports:

_____________________________________________________________________________

Cultural:

_____________________________________________________________________________

Academic:

_____________________________________________________________________________

Has your daughter been stood down No

 Yes 

or suspended No



Yes

 from school?

This part is to be written by the student: Reason why I would like to come to Tauranga Girls’ College and what I will contribute to the College. ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

Tauranga Girls’ College Contract I/We apply for the enrolment of

…………………………………………………………………………….

at Tauranga Girls’ College. If that application is accepted by the Board of Trustees then: 1.

The student agrees to follow the School Values set out in the Tauranga Girls’ College Prospectus and website. In particular, this includes Manaakitanga (Respect), Mahi Tahi (Participation) and Mana Motuhake (Pride). The College has high expectations of behaviour and conduct in and representing the College. Consequences can be expected for those not meeting our expectations. This includes the wearing of correct uniform in accordance with out uniform rule.

2.

The Parents/Caregivers: The Board of Trustees has the power to annul an enrolment if it is found to be based on false information.

Parents and/or caregivers are required to certify that the statements in this application form are correct.

I/We agree: (a) That the information provided in this application is true and correct. (b) To support and encourage the student in her education at Tauranga Girls’ College in accordance with the College’s expectations. (c) To consult with the College if at any time the parent or caregiver believes that either the College or the student are not meeting their obligations. (d) To the applicant’s records being obtained from her previous school. (e) To the applicant’s print and online publication of student images and work for learning and teaching and communication purposes. (f) To support and encourage the student to engage in and represent the College in and beyond classroom learning. This includes sport, cultural, arts and academic opportunities.

3.

The Board of Trustees agrees to provide the student with education in terms of the Charter of Tauranga Girls’ College.

4.

The school is sometimes obliged by law to give information to Government Departments (eg the Ministry of Education, and the Ministry of Health) but except for contact details explained below, your information will not otherwise be disclosed without your authorisation.

Address and phone number details are collected at the time of enrolment and during the student’s time at school so that the school can contact the parent or student as necessary. These contact details may also be passed on to the Ministry of Education and the Ministry of Social Development (MSD). This is so young people who may have difficulty finding future employment; training or further education can be identified and offered support by organisations contracted by MSD to help re-engage young people in education or training when they leave school.

Signed:

……………………………………………………..

(Student)

Signed:

……………………………………………………..

(Parents/Caregivers)

……………………………………………………..

Date

………/………/20……

Signed: ……………………………………………………..

Tauranga Girls’ College Board of Trustees Date of Acceptance:

Tauranga Girls’ College Values “empowering tomorrow’s women”

RESPECT (Manaakitanga)    

Be positive, caring and encouraging Be accepting of difference Respect other people’s right to learn Have good manners and act with integrity

PARTICIPATION (Mahi Tahi)    

Aim high and get involved Show leadership Meet deadlines and commitments Be on time and prepared to learn

PRIDE (Mana Motuhake)  Be the best we can be   Be proud of ourselves and of our achievements  Be proud to be problem solvers and innovators  Be proud to be a member of our diverse school community “By encouraging individual responsibility, integrity and respect for the rights of others”

Tauranga Girls’ College Internet User Agreement Tauranga Girls’ College has very good Wi-Fi coverage across the school to allow students (with permission from their classroom teachers) the opportunity to use their digital devices to support their learning.

Please read the following carefully to ensure you understand our expectations which are underpinned by our Colleges values and NZ Law such as the Harmful Digital Communications Act (2015).

To use internet access computers: 1 Students must have completed and returned the “Internet User Agreement & Parent Permission Form”.

2 Any email use may be checked.

3 Regular, random checks of a computer’s internet history files will be made.

4 Where a student abuses the network she shall be immediately reported to a Deputy Principal and the computer concerned shall be quarantined and inspected.

5 If a student suffers a ban as a consequence of improper use of the network, she needs to be aware that this may disqualify her from any school course involving computer use and that this may have serious consequences for her learning. We expect students to take responsibility as underpinned by our schools values.

6 Please note that students may not access social media sites at school and use of those sites which the College believes has the potential to cause ‘harm’ (as defined by Netsafe in the HDC Act 2015) to others (see also Discipline policy).

Students may lose all internet access across all their subjects plus have other disciplinary action taken if they commit any of these actions:  Download or cause to be downloaded offensive messages, graphics, pictures or obscene language.  Wilfully use email to send harmful or offensive messages.  Damage computers intentionally, computer systems, computer networks.  Use or possess any network management or security software.  Trespass in staff or student files.  Wilfully use or be found in possession of computer viruses.  Violate New Zealand law or regulations including copyright laws.  Use the network for commercial purposes or in any manner that brings discredit upon the College.  Print material which is not connected to College work.  Delete history files.  Use Proxy/VPN websites to bypass school Internet filters.

Permission  I have read and understood the Tauranga Girls’ College statement on the use of the internet.  I agree to obey the rules as laid out in this document.  I understand that if I break any of these rules I may be banned from any further use of College computer equipment.  I agree to read the HDC Act 2015 to ensure I understand this law as described by Netsafe  As parents/whanau we agree to ensuring that we are monitoring our daughters internet/social media use and if we have concerns, will contact the tutor teacher and/or Dean if necessary Name of student: .............................................. Tutor Group: .........

Date: ...../...../20….

Student signature: ............................................ Parent/Legal Guardian Signature: .........................................

Contact phone number:

........................................ (day) ...................................... (night)

Medication Authorisation/Disclaimer

I/We ..................................................................... caregivers of ………………............................., Tutor Class: …………wish for her to receive prescription medication at school on a regular basis as outlined by the prescribing Doctor.

Name(s) of the Medication:

....................................................................................................

Dosage:

....................................................................................................

Prescribed by:

....................................................................................................

1

Attached to this form is written verification of the need for the medication and the correct dosage and possible side effects from the prescribing Doctor.

2

We are aware that the Board of Trustees and its employees will not accept any responsibility for accidental or incorrect dosage, the failure by the student to take her medication when prescribed or claims for any long-term side effects.

3

We are aware that it is our daughter’s responsibility to arrive at the office/health centre at the appropriate time to receive the medication.

4

Your daughter’s time is ...................................................................................

5

I/We acknowledge receipt of a copy of the Board of Trustees current policy on medication and its administration and confirm that I/We have read and understood this policy.

Signed: …………………………………………………………………..

Tauranga Girls’ College 930 Cameron Road Tauranga 3112 New Zealand

Telephone: Facsimile: email: Website:

Date: …../……./20…….

07 578 8114 07 578 8447 info@tgc.school.nz http://www.tgc.school.nz

Tauranga Girls’ College Enrolment Checklist 

Complete your Application Form.



Complete your Subject Request Form.



Include a photocopy of your daughter’s most recent school report.



Include a photocopy of any examination results if your daughter is enrolling for Year 12 or Year 13.



Include proof of residence in the Tauranga Girls’ College zone; a copy of a household account such as a rental agreement, rate notice, electricity or telephone account that clearly shows the address and caregivers name.



Include a photocopy of your daughter’s New Zealand Birth Certificate or Passport showing residency status.



Make an appointment for an interview through your contributing school or telephone the College on (07) 578-8114.



Medication form completed and included if applicable.



Completed Internet User Agreement.



Learning Support/Gifted and Talented.



Mobile Adolescent Dental Service (MADS) application completed (if required).