In Zone Enrolment
ID:0 | 05/10/2022 |

Recipient: Guest
Originator: Guest
1 1. Application Information
1. Application Information
2 2. Immigration Status
2. Immigration Status
3 3. Caregiver Details
3. Caregiver Details
4 4. Caregiver 2
4. Caregiver 2
5 5. Student`s Special Learning Needs
5. Student`s Special Learning Needs
6 6. Student Health Record
6. Student Health Record
7 7. Courses
7. Courses
8 8. BYOD
9 9. Cybersafety
9. Cybersafety
10 10. The Selwyn Way
10. The Selwyn Way
* Mandatory fields | 
About Yourself

This is an application for in zone students. If you do not live in our zone  please use the Out of Zone form instead.

In order to complete this form you will need to provide several scanned documents: proof of residence (a photo or scanned copy of a rates bill or rental agreement and a utilities bill) and identification for your student (a scanned copy or photo of their passport, birth certificate or visa). If you cannot complete this form please contact our office for assistance.

Name of the person completing this form *

Email Address *

Are you in zone for Selwyn? *

Do you have other immediate family members currently or recently enrolled at Selwyn College?

What are the full name(s) of other family member(s) currently attending Selwyn College and what is the nature of relationship(s)  (i.e. sibling, cousin etc) (e.g. John Bloggs - step-sibling) 

House of other family members:

I give permission for senior Selwyn College staff to discuss matters relating to my child's learning with staff at their previous school. *
Student Personal Details

Legal surname: *

Preferred Surname: *

First Name:

Middle Name

Name preferred to be known by:


Students Residential Address: Number and Street




Tenancy agreement or rates: *

Recent Power Bill *

You will also need to download this Statutory Declaration form, complete it and bring it with you to your interview.

Student Mobile:

Student email:

Date of Birth:

Incoming Year Level:

Intended start date (choose 02/02/2023 for next year): *

Country of Birth:

Country of Citizenship:

Either Birth Certificate Number or Passport Number:

Upload evidence (scan a copy of your NZ passport, NZ birth certificate etc)

You may choose up to three ethnicities.


Iwi affiliations

You can identify up to three affiliations here - if you need more please let us know during the enrolment process

Iwi affiliation(s):

Student Personal Details

First Language:

Previous School in New Zealand / Overseas:

School report:

National Students Number (NSN):
Immigration Status

What is your citizenship status?:

Date of arrival in New Zealand:

Permit expiry date:
Caregiver Details

Family Name:

First Name(s):


Relationship to Student:

Home Phone:

Mobile Number:

Work Phone:



Name of Employer/Company:

Please tick the items that apply to Caregiver 1:
Caregiver 2

Enter details for a second caregiver, if residential details are the same as for caregiver one please leave these fields blank.

Family Name:

First Names:


Relationship to student:

Do you live with this student?

If not living with student - residential address: Number and Street



Post code:

Home Phone:

Mobile Phone Number:


Work phone:


Name of Employer/Company:

If this caregiver does not live with the student, do you require mail concerning student welfare to be sent to both caregivers?

Please check the items that apply to Caregiver 2:

Do you wish to have fees and charges split between caregivers 1 and 2?

Please upload any relevant evidence of caregiver arrangements (e.g. custody documents or court orders).
Student's Special Learning Needs

Please describe any special learning needs:

Comments / Sensitive Data. Please give any specific information that we should be aware of in relation to caregiver/custody arrangements or any other information that may affect this student's learning.

Please upload any documents relating to student learning (e.g. EdPsych report)