Enrolment Application Year 0-13 One form to be completed in full for each applicant

Before completing this form please read the BC Enrolment Policy
I have read and understand the terms of the Enrolment Policy*
STUDENT INFORMATION
SURNAME:*
FIRST NAMES:*
PREFERRED NAME:
SEX:*
DATE OF BIRTH:*
NZ CITIZEN:*
ETHNICITY:*
If NZ Maori descent, please enter the name/s of his/her Iwi:
If not a NZ Citizen, please state the student's Immigration Status:*
*If not a Resident, a copy of the student visa will be required. Without a current student visa or residency the student will not be able to enrol at Bethlehem College. Alternatively the student will need to enrol as an International student, please refer to the International page on this site.
Are you a migrant to NZ in the last 3 years? If yes, what was your date of arrival in NZ and country of origin?
Language spoken at home, other than English
HEALTH: Please advise of any serious health issues.
EDUCATION
WHICH CAMPUS DO YOU WISH TO ENROL AT
PREFERRED LEVEL OF ENTRY TO

BC Years 1-13

BCC Years 1-8:
YEAR LEVEL
YEAR OF ENTRY to BC/BCC
PRESENT SCHOOL/PRE-SCHOOL:*
I give permission to BC to contact my child's present school for additional information*
PRESENT YEAR LEVEL

FAMILY INFORMATION
Parent / Caregiver 1 - Person submitting Application
RELATION TO CHILD:*
SURNAME*
FIRST NAME (S)*
STREET ADDRESS:*
SUBURB:*
CITY:*
DAYTIME PHONE
MOBILE:*
EMAIL:*
OCCUPATION:
CHURCH / CHRISTIAN GROUP ATTENDING:*
Parent / Caregiver 2
RELATION TO CHILD:*
SURNAME*
FIRST NAME (S)*
Please include information below if different from Caregiver 1.
STREET ADDRESS:
SUBURB:
CITY:
DAYTIME PHONE
MOBILE:
EMAIL:
OCCUPATION:
CHURCH / CHRISTIAN GROUP ATTENDING:

BILLING / ACCOUNTS
Please specify the billing name:
Billing Address
Financial Commitment
Bethlehem College is a State Integrated school and has a reasonable level of both compulsory and non compulsory fees (which we expect all families to support). It is important all prospective new families are realistic in their ability to be able to afford the level of financial commitment required to attend the school. If you consider you may have financial difficulties in meeting the normal fee requirements, it is important this aspect is further discussed at the initial interview.
We acknowledge we have read and understood the fees as detailed in the fee schedule of the prospectus.
true
Name of sibling(s) already attending BC and Year level:
Name of sibling(s) also applying for a place at BC:
Student Address
CHRISTIAN COMMITMENT
As Bethlehem College has integrated into the state system, 90% of the parents of new students need to be able to demonstrate a personal commitment to the Evangelical Christian faith which defines the Special Character of the College.
Reason for seeking a place at BC:
Christian Aspect of Parents / Caregivers*
Prospective student - Interest in attending BC:
Prospective student - Regular attendant of a church / youth group:

YesNo
Prospective student - Has an active faith of his / her own:

YesNo

DOCUMENTATION CHECKLIST
Declaration of Special Character
Please tick an initial acceptance of the following Declaration, then print a copy from the Enrolment Documents page and sign. This will need to be included with other required documentation forwarded to the Registrar. (Your acceptance or non acceptance will not prejudice your enrolment process.)
Special Character Conditions: - I / We and have read the Statement of Special Character & Belief on the Enrolment page of this site - I / We support and endorse its clauses - I / We understand: + Bethlehem College is an openly Christian school staffed by committed Christian staff + that my child will be taught the Christian faith as both belief and a way of life + that my child will be expected to participate in class devotions and attend Christian services + that my child will be required to show respect for the right of others to participate in Christian learning and worship activities
I / We Accept the Statement of Special Character
AcceptUnable to accept
Church Reference
Parents should approach their church pastor/minister to complete the on-line reference - found under the Enrolment Documents page.

Yes (Reference to follow)No (N/A)
Declaration of Learning Support (Please disregard this section if it is not applicable)
My child is currently receiving special assistance (or has in the recent past) to support his or her learning or behavioural needs.

true
My child receives government funding to assist with his/her learning needs.

true
If any of these two options are applicable to your child, please indicate what kind of assistance, why this assistance is required and what type of government funding:
Please forward the following documents to the Registrar:

- Signed Statement of Special Character & Belief
- Two most recent School Reports
- Copy of birth certificate or current passport

The Enrolment process will only be completed on receipt of all these documents.
THANK YOU
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