ACG Sunderland Preschool
Online Application for Enrolment

Child Information

* Required fields

Child’s legal first name *

Child's legal last name *

Child’s legal other names / middle names: (please separate names with a comma)

Preferred first name * Name your child is known by

Preferred last name * Name your child is known by

Date of Birth *

Gender *

Male Female

Language/s spoken at home * Select up to three

Child’s ethnic origin/s * Select up to three

Supporting Documents

Please upload one of the following verification documents (If available).

New Zealand birth certificate

Upload

New Zealand passport

Upload

Foreign birth certificate

Upload

Foreign passport

Upload

Health Information

Family Doctor *

Doctor's Phone *

Allergies, Special Needs, Health Problems *

Yes No

Is your child on the Immunisation Programme? *

Yes No

Please attach a copy of the Childs Immunisation record found on the back of the Plunket Book, or bring in when you see us

Upload

A category (i) medicine is a non-prescription preparation (such as arnica cream, antiseptic liquid, insect bite treatment) that is not ingested, used for the ‘first aid’ treatment of minor injuries and provided by the service and kept in the first aid cabinet.

Do you approve category (i) medicines to be used on your child? *

Yes No

ACG Sunderland Preschool Online Application for Enrolment

ACG Sunderland Preschool
Online Application for Enrolment