This enrolment form is for Waiuku Primary School.

This is a provisional enrolment form based on the following information being provided to the school:

Student Details

Please include your child's middle name.

Ethnicity
Student's Address
Contact 1

This is the Primary Contact for this student.

Contact 2

This is the Secondary Contact for this student.

Contact 3
Emergency Contacts

This must be a person other than Contact 1 or Contact 2.