Tibbs House Boarding Application
ID:0 | 04/12/2024 |
Recipient: Guest
Originator: Guest
1 1. General Student Information
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2 2. Particulars of Caregivers
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3 3. Address Information
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4 4. Emergency Contact Details
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5 5. Proof of Identity
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6 6. Other Particulars
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7 7. Personal Profile
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8 8. Privacy of Information
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9 9. Communications
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10 10. Administration Fee
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11 11. Please Note:
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* Mandatory fields | 
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1
Recipient Details

Full Name of person completing this application *

Email Address of person completing this application *
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General Information

Please select the year you are applying for *

Select the Form Level for which you are applying: *


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Please Note:

Complete all fields in lower case with a Capital for the first letter e.g John Smith not JOHN SMITH
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Particulars of Student





Student Surname *

Student Legal Surname *

Student Legal First Name *

Student Legal Middle Name

Student Legal First and Middle Initials (e.g. A.B.) *

Date of Birth *

Country of Birth *

Home Phone

Student Mobile
Student Email Address

Residential Address *

Suburb *

City / Town *

Post Code *

All students arriving from overseas, Date of Arrival in NZ
Eligibility *

Current School (or last attended) If Last School was not in NZ please select Overseas *

Primary Ethnicity *

Iwi (if NZ Maori)
If more than one Ethnicity please select all that apply

First Language *

Nationality *

Name of brother/s currently or previously at AGS & Class









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Interests and Achievements

Sporting interests

Musical, Culturalor Dramatic pursuits:

Other Activities: (hobbies, personal and community interests)
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Particulars of Caregiver 1

Relationship to Student *

First Name *

Surname *

Title *

Occupation

Email Address *

Home Phone

Work Phone

Mobile Phone *

Currently Living with Student *

Legal Access to Student

Eligibility

If you live at a different address from the student, do you wish to receive copies of the School report

If you live at a different address from the student, do you wish to receive financial requests
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Particulars of Caregiver 2

Relationship to Student *

First Name *

Surname *

Title *

Occupation

Email Address *

Home Phone

Work Phone

Mobile Phone *

Currently Living with Student *

Legal Access to Student

Eligibility

If you live at a different address from the student, do you wish to receive copies of the School report

If you live at a different address from the student, do you wish to receive financial requests
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Particulars of Caregiver 3

For boarding families who live outside of the Auckland City boundaries, an Auckland City based contact must also be supplied.

Relationship to Student

First Name

Surname

Title

Occupation

Email Address

Home Phone

Work Phone

Mobile Phone
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Address Information

Primary Correspondence Postal Address

Mail to Whom: (e.g Mr A & Mrs D Smith) *

Address *

Suburb *

Town / City *

Post Code *

Country *

Who resides at this address *

Primary Email Contact *
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Alternate Correspondence Address

ONLY Use if Caregiver 1 / Caregiver 2 / Caregiver 3 do not reside at the Primary Correspondence Address

Mail to Whom: (e.g Mr B Smith)

Address

Suburb

City / Town

Post Code

Country

Who resides at this address

Alternate Email Contact
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Emergency Contact Details

Please provide an emergency contact in Auckland (this cannot be a parent or caregiver. Parents will be called first but in the event there is no answer this contact will be called)

Full Name and Relationship to Student 
e.g Mrs Amanda Smith (Friend) *

Contact Number (Preferably Mobile) *
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For all Students

Please Note:

  • Each Question can only upload one file.
  • All Pages for each question have to be scanned as one document.

Birth Certificate - English Translation if necessary *

Latest school report - English Translation if necessary *

Students born in New Zealand after 1 January 2006 who are NOT New Zealand citizens by birth must provide proof of ONE of the following:

- Citizenship Certificate
- New Zealand Passport
- Residence Permit / Visa
- An applicable current Student Visa
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Proof of Identity - Students born OUTSIDE New Zealand

NZ Citizens: New Zealand passport or citzenship certificate

All other students: First page of passport.

All other students: Residency Permit / Visa or Student Visa, together with parents’ passports and residency or work visas




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Please upload here any additional Reports / References / Awards that may support your application

Additional Documents #1

Additional Documents #2

Additional Documents #3

Additional Documents #4

Additional Documents #5
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Other Particulars

Please list your reasons for wishing to attend Auckland Grammar School. (This question is to be answered by both the parents and by the boy.)

Parents’ reasons:

Boy’s reasons:
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Please record any family connection your son has with Auckland Grammar School.

Name:
Year:

Name:
Year:

Name:
Year:

Name:
Year:
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Other Particulars continued

Please tick if father is a current financial member of the Old Boys’ Association.

Please record any other significant connection your son might have with Auckland Grammar School.

Please record any other school(s) for which you have applied.

Please record details of the school you are currently in zone for

Please record the details of a contact person at your current school to act as a reference for your application.

Your nominated contact person may receive a brief profile questionnaire on your son via email. Please notify them of this possibility and ensure
that they are happy to complete such a form before writing their name down, as this profile questionnaire is an important part of your son's
application.

Contact person e.g. Classroom teacher or Dean*:

Position:

Email address:
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Personal Profile

To be completed by the boy

Please upload a paragraph telling us about yourself. Include details of the school you currently attend, your family, where you have lived and the things you enjoy being involved in.
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Privacy of Information

I agree to Auckland Grammar School collecting personal information on:

Full Name of Parent/Guardian *

Full Name of Student *

I acknowledge that the information I provide in relation to the student’s enrolment, and such updated information and other personal information collected from time to time by Auckland Grammar School, is collected for the purpose of: 

  • the Board and/or the School discharging their functions and obligations under the Education and Training Act 2020;
  • the administration of Auckland Grammar School;
  • providing for the student’s educational and general advancement;
  • maintaining student records;
  • accounting purposes of the Auckland Grammar School Board of Trustees;
  • communication with the Guardians/Parents of students;
  • incident reporting and the sharing of information to improve the health and safety and wellbeing of all at Auckland Grammar School; and
  • communication with Alumni, Auckland Grammar School Development Office, Auckland Grammar School Old Boys’ Association, NZ Qualifications Authority examination information, Special Education Services,  the Ministry of Social Development (Youth Services) and any other Government agency which may lawfully request such information from time to time.

I further accept that this information may later be used for statistical and/or research purposes and agree to its use for that purpose, provided that if the information is published in any way it will not identify me or the student. 

I authorise Auckland Grammar School to obtain from any person or organisation any of the student’s personal information required for the purposes of the Board and/or the School discharging their functions and obligations under the Education and Training Act 2020, and I authorise that person or organisation to disclose such personal information to Auckland Grammar School and/or the Board of Trustees of Auckland Grammar School.

I give Auckland Grammar School permission to use the student’s likeness in visual images in any of its publications including website entries; and in the media, without payment or any other consideration. 

I am aware that, pursuant to the Privacy Act 1993, I have the right to access and correct my/the student’s personal information held by Auckland Grammar School. I shall notify the school of any change in my/the student’s personal information held by Auckland Grammar School as soon as is reasonably practicable. * *


I acknowledge that the information I provide in relation to my enrolment, and such updated information and other personal information collected from time to time by Auckland Grammar School, is collected for the purpose of: 
 

  • the Board and/or the School discharging their functions and obligations under the Education and Training Act 2020;
  • the administration of Auckland Grammar School;
  • providing for my educational and general advancement;
  • maintaining student records;
  • accounting purposes of the Auckland Grammar School Board of Trustees;
  • communication with the Guardians/Parents of students;
  • incident reporting and the sharing of information to improve the health and safety and wellbeing of all at Auckland Grammar School; and
  • communication with Alumni, Auckland Grammar School Development Office, Auckland Grammar School Old Boys’ Association, NZ Qualifications Authority examination information, Special Education Services,  the Ministry of Social Development (Youth Services) and any other Government agency which may lawfully request such information from time to time.

I further accept that this information may later be used for statistical and/or research purposes and agree to its use for that purpose, provided that if the information is published in any way it will not identify me. 

I authorise Auckland Grammar School to obtain from any person or organisation any of my personal information required for the purposes of the Board and/or the School discharging their functions and obligations under the Education and Training Act 2020, and I authorise that person or organisation to disclose such personal information to Auckland Grammar School and/or the Board of Trustees of Auckland Grammar School.

I give Auckland Grammar School permission to use my likeness in visual images in any of its publications including website entries; and in the media, without payment or any other consideration. 

I am aware that, pursuant to the Privacy Act 1993, I have the right to access and correct my personal information held by Auckland Grammar School. I shall notify the school of any change in my personal information held by Auckland Grammar School as soon as is reasonably practicable. * *

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How did you hear about us?

How did you hear about us?

If 'Other Means' please provide further details:
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Administration Fee

Non-refundable fifty dollar ($50.00) administration fee


Administration Fee Total: 0
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Please Note:

Notes Relating to the Completion of the Application Form

PART ONE - General Information

A: Particulars of Boy

  • The address for all return mail will be the “Boy’s Residential Address”.
  • The address given should be the boy’s usual home address.
  • If the boy spends lengthy periods at another address then thataddress should be noted.


C: Particulars of Parents, D: Emergency Details

  • The word ‘parents’ on other sections of the Application Form should be taken to include natural parents, guardian or caregiver. Caregiver is a term used by the Ministry of Education to describe the person(s) taking care of the boy. The School understands that in most cases, this/these person(s) is/are the parent(s) of the boy. If the boy is living other than with his parent’s we require a legal guardianship agreement. This information is required for the Auckland Grammar School Board of Trustees Parents’ Representative Roll. Addresses given remain confidential to the School.
  • The Emergency Contact should be a relative or neighbour who can be contacted during the day by the School should some medical or other unforeseen emergency arise. The Emergency Contact will be rung only if neither parent can be contacted.
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