Office Use Code Accepted WANGANUI HIGH SCHOOL Acc. Pack Sent Purnell Street, PO Box 4022, Wanganui, 4541, Entered on KAMAR Telephone: 06 349 0178, Facsimile: 06 349 0176 Notify AP and Dean Student Number PRE-ENROLMENT APPLICATION FORM FOR 2012

STUDENT DETAILS Surname/Last Name: First Names: (As on birth certificate) (As on birth certificate - underline preferred name)

Gender: Home Phone: Date of Birth: Intended Start Date: Male Female

Home Address: Postal Address: (Include postcode) (If different from home address)

Type of Student: School Zone: Regular Student Will the student be living in the School Zone when he/she starts at WHS? Exchange Student (see school enrolment scheme enclosed) International Student Yes No

DEMOGRAPHICS Tick  as appropriate Student’s year level Residency Status: First Language: Ethnic Origin: if accepted will be: (you may tick more than one) New Zealand Citizen What language does the Year 9 Permanent Resident student speak at home? Maori * Year 10 Student Visa NZ European / Pakeha English Year 11 Other (please specify below) European Year 12 Other (please specify below) Pacific Islands Year 13 ______(please specify below) ______

Student’s Current School: ______Other (please specify below) ______Citizenship: ______Country of birth: ______*Indicate affiliation on separate sheet (see enclosed)

ENROLMENT INFORMATION Tick  which of these apply.  Applicant has a sibling who is a current student Below please list the names of sibling/s who are current or of Wanganui High School former students OR parent/s who are former students.  Applicant has a sibling who is a former student of Wanganui High School ______ Applicant is the son/daughter of a former student of Wanganui High School ______ Applicant is the son/daughter of an employee of the Wanganui High School Board of Trustees or ______the son/daughter of a member of the Wanganui High School Board of Trustees ______

LEARNING / MEDICAL INFORMATION Name of Doctor: Name of Dentist:

Special Circumstances: Special Circumstances:

Are there any special learning or medical concerns that the Are there any support agencies working with your son/daughter? school should be aware of? For example: Life to the Max; CAMHS etc. Learning: Yes No Medical: Yes No

If so please provide details by attaching further information.

PRIMARY CAREGIVERS (Parent/Caregiver with whom the student lives) FEMALE (Mrs / Ms / Miss) MALE Name: Name: Relationship to Student: Relationship to Student: (eg. mother) (eg. father) Legal Guardian Yes No Legal Guardian Yes No Cell Phone: Cell Phone: Email: Email: Occupation: Occupation: Work Phone: Work Phone: Place of employment: Place of employment: SECONDARY CAREGIVERS (Parent/Caregiver if different from Primary Caregivers above) FEMALE (Mrs / Ms / Miss) MALE Name: Name: Relationship to Student: Relationship to Student: (eg mother) (eg father) Legal Guardian: Yes No Legal Guardian: Yes No Home Phone: Home Phone: Cell Phone: Cell Phone: Email: Email: Address: Address:

Work Phone: Work Phone: Place of employment: Place of employment: EMERGENCY CONTACT DETAILS IN AN EMERGENCY who else can we contact? Name: Relationship to Student: Home Phone: Work Phone: Cell Phone:

I hereby acknowledge that I have read and understood Wanganui High School’s Enrolment Scheme (a copy of which was provided with this enrolment form). I hereby make application to enrol my son/daughter at Wanganui High School and agree that if he/she is admitted, he/she will be subject to the rules and discipline of the school, will adhere to the school's uniform policy, and will attend as required. I further undertake to pay any activity fee and material charges levied by the Board of Trustees. I undertake to provide all information and particulars relating to guardianship and legal access where relevant, and to allow the school to share such information as necessary to meet the needs of my son/daughter. I understand that the school will contact me, in writing, in order to confirm whether or not my son/daughter has been accepted. I confirm that the address which I have provided to the school will be the usual place of residence of my son/daughter when the school is open for instruction. I will promptly advise the school of any subsequent change of address.

I enclose the following documents as part of my son/daughter’s application for enrolment:

Copy of the student’s birth certificate (if born in NZ) or current passport with relevant visa / permit Course selection sheet (if born outside of NZ) Iwi affiliation declaration (if applicable) A copy of the student’s latest school report

Signature of Parent(s) or Caregiver(s):

1.______2.______

Signature of Student: ______Date: ______

Iwi Codes and Regions 0709  Ngati Kahungunu ki Tamakinui a Rua Student Name: ______0700  Te Matau a Maui/Wairarapa (Hawkes Bay/Wairarapa) Northland/Auckland : Te Tai Tokerau/Tamaki Makau Rau Region Region, not further defined 0101  Te Aupouri 0102  Ngati Kahu Region 0103  Ngati Kuri 0801  Te Atiawa (Taranaki) 0104  Ngapuhi 0802  Ngati Maru (Taranaki) 0105  Ngapuhi ki Whaingaroa-Ngati Kahu ki Whaingaroa 0803  Ngati Mutunga (Taranaki) 0106  0804  Nga Rauru 0107  Ngai Takoto 0805  Nga Ruahine 0108  Ngati Wai 0806  Ngati Ruanui 0109  Ngati Whatua 0807  Ngati Tama (Taranaki) 0110  Te Kawerau 0808  Taranaki 0111  Te Uri-o Hau 0809  Tangahoe 0112  0810  Pakakohi 0100  Te Tai Tokerau/Tamaki Makau Rau (Northland/Auckland) 0800  Taranaki (Taranaki) Region, not further defined Region, not further defined Wanganui/Rangitikei Region Coromandel : Hauraki Region 0901  Ngati Apa (Rangitikei) 0201  Ngati Hako 0902  Te Ati Hau Nui-A-Paparangi 0202  Ngati Hei 0903  Ngati Haua (Taumarunui) 0203  Ngati Maru (Marutuahu) 0904  Ngati Hauiti 0204  Ngati Paoa 0900  Whanganui/Rangitikei (Wanganui/Rangitikei) Region, not 0205  Patukirikiri further defined 0206  Ngati Porou ki Harataunga ki Mataora 0207  Ngati Pukenga ki Waiau Manawatu/Horowhenua/: 0208  Ngati Rahiri Tumutumu Manawatu/Horowhenua/TeWhanganui a Tara Region 0209  Ngati Tai 1001  Te Atiawa (Te Whanganui a Tara/Wellington) 0210  Ngati Tamatera 1002  Muaupoko 0211  Ngati Tara Tokanui 1003  Rangitane (Manawatu) 0212  Ngati Whanaunga 1004  Ngati Raukawa (Horowhenua/Manawatu) 0200  Hauraki (Coromandel) Region, not further defined 1005  Ngati Toarangatira (Te Whanganui a Tara/Wellington) 1006  Te Atiawa ki Whakarongotai /King Country : Waikato/Te Rohe Potae Region 1000  Manawatu/Horowhenua/TeWhanganui a Tara 0301  Ngati Haua (Waikato) (Manawatu/Horowhenua/Wellington) Region nfd 0302  Ngati Maniapoto 0303  Ngati Raukawa (Waikato) / : Te Waipounamu/Wharekauri Region 0304  Waikato 0300  Waikato/Te Rohe Potae (Waikato/King Country) Region, 1101  Te Atiawa (Te Waipounamu/South Island) not further defined 1102  Ngati Koata 1103  Ngati Kuia Rotorua/Taupo : Te /Taupo Region 1104  Kati Mamoe 0401  Ngati Pikiao () 1105  0402  Ngati Rangiteaorere (Te Arawa) 1106  Ngati Mutunga (Wharekauri/Chatham Islands) 0403  Ngati Rangitihi (Te Arawa) 1107  Rangitane (Te Waipounamu/South Island) 0404  Ngati Rangiwewehi (Te Arawa) 1108  Ngati Rarua 0405  (Te Arawa) 1109  Ngai Tahu / Kai Tahu 0406  Tarawhai (Te Arawa) 1110  Ngati Tama (Te Waipounamu/South Island) 0407  Tuhourangi (Te Arawa) 1111  Ngati Toarangatira (Te Waipounamu/South Island) 0408  Uenuku-Kopako (Te Arawa) 1112  Waitaha (Te Waipounamu/South Island) 0409  Waitaha (Te Arawa) 1113  Ngati Apa ki te Waipounamu 0410  Ngati Whakaue (Te Arawa) 1100  Te Waipounamu/Wharekauri (South Island/Chatham 0411  Ngati Tuwharetoa Islands) Region, nfd 0412  Ngati Tahu (Te Arawa) 0400  Te Arawa/Taupo (Rotorua/Taupo) Region, not further Iwi unknown, but and iwi confederation known defined 2001  2002  Te Arawa Bay of Plenty : /Matatua Region 2003  Takitimu 0501  Ngati Pukenga 2004  Aotea 0502  Ngaiterangi 2005  Matatua 0503  Ngati Ranginui 2006  Mahuru 0504  Ngati Awa 2007  Mamari 0505  Ngati Manawa 2008  Ngatokimatawhaorua 0506  Ngai Tai 2009  Nukutere 0507  Tuhoe 2010  Tokomaru 0508  Whakatohea 2011  Kurahaupo 0509  Whanau-A-Apanui 2012  Muriwhenua 0510  Ngati Whare 2013  Hauraki / Pare Hauraki 0500  Tauranga Moana/Matatua (Bay of Plenty) Region, not 2014  Turanganui a Kiwa further defined 2015  Te Tauihu o Te Waka a Maui 2016  Tauranga Moana East Coast: Te Tairawhiti Region 2017  Horouta 0601  Ngati Porou 0602  Te Aitanga-A-Mahaki Iwi known, but region unspecified 0603  Rongowhakata 2101  Te Atiawa, region unspecified 0604  Ngai Tamanuhiri 2102  Ngati Haua, region unspecified 0600  Te Tairawhiti (East Coast) Region, not further defined 2103  Ngati Maru, region unspecified 2104  Ngati Mutunga, region unspecified Hawkes Bay/Wairarapa: Te Matau a Maui/Wairarapa Region 2105  Rangitane, region unspecified 0701  Rongomaiwahine (Te Mahia) 2106  Ngati Raukawa, region unspecified 0702  Ngati Kahungunu ki 2107  Ngati Tama, region unspecified 0703  Ngati Kahungunu ki Heretaunga 2108  Ngati Toa, region unspecified 0704  Ngati Kahungunu ki Wairarapa 2109  Waitaha, region unspecified 0705  Ngati Kahungunu, region unspecified 2110  Ngati Apa, area unspecified 0706  Rangitane (Te Matau a Maui/Hawkes Bay/Wairarapa) 2200  Hapu Affiliated to More Than One Iwi 0707  Ngati Kahungunu ki Whanganui a Orotu 0708  Ngati Kahungunu ki Tamatea

B

YEAR 12and13COURSE INTENTION SHEET 2012

Name: ………………………………………………………… 2011 Form Class: ………………

Please tick one of the following: I am definitely returning to Wanganui High School in 2012

I am probably returning to Wanganui High School in 2012

I am probably leaving Wanganui High School at the end of 2011

I am definitely leaving Wanganui High School at the end of 2011

* If you are definitely leaving, tick the "Leaving Wanganui High School" box, write here what you are going to be doing in 2012, and do not fill in this sheet any further.

Destination: ______

* If you change your mind about returning to Wanganui High School, you must inform the Student Centre as soon as possible.

HOW TO FILL OUT THE REST OF THIS FORM All Year 12 students must study English and are strongly advised to study Mathematics. There are no compulsory subjects for Year 13 students.

Subject Choices:

 Please circle or highlight your seven (7) selected subjects on the back of this page.

 Make sure you choose only subjects for which you expect to achieve the entry requirements.

 Make sure your selected subjects are clearly marked. If you need to make a correction, collect a new copy of the form from the Student Centre.

 Select an eight subject. This is in case one of your seven subject choices is unavailable to you for any reason, e.g. timetable clashes. You will be contacted if we need to use this subject choice.

My 8th subject choice is: ______

 Please tell us what possible career destinations you are considering, and what possible tertiary courses you may be interested in.

______

Parent Signature: ……………………………………… Student Signature: ………………………………….

Notes: Course counsellors are available at school to assist students. Parents/caregivers should contact the Student Centre if they wish to have an interview with a course counsellor.

LER