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the jewel in the crown

POto College House

The Wairarapa’s only co-educational boarding facility

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Enrol

Complete The Form Below

My child/ward's full name *

First

Last

Preferred name if different to above

I wish to enrol my child/ward at College House as a boarder in year *

Year of Entry *

Is child/ward an overseas student? *

Yes
No

Date of Birth *

Present School *

Year Level *

Nearest Secondary School *

Distance in Kilometres *

Distance from nearest bus route in kms *

First Guardian Name *

First

Last

First Guardian Home Address *

First Guardian Phone - Home *

First Guardian Phone - Work

First Guardian - Mobile *

First Guardian - Email *

Second Guardian Name *

First

Last

Second Guardian Home Address *

Second Guardian Phone - Home *

Second Guardian Phone - Work

Second Guardian Phone - Mobile *

Second Guardian - Email *

Emergency Contact if Parent or Legal Guardian is unavailable *

First

Last

Relationship to Student *

Emergency Contact Address *

Emergency Contact Phone - Home *

Emergency Contact Phone - Work

Emergency Contact Phone - Mobile *

Medical Information - Doctor's Name *

First

Last

All information is strictly confidential

Doctor's Phone Number *

Dentist's Name *

First

Last

Dentist's Phone Number *

Does your child suffer from any of the following - please tick all that apply *

Asthma
Hayfever
Food Allergy
Insect Bite/Sting Allergy
Antibiotic Allergy
Diabetes
None of the Above

Where to send newsletters

Guardian 1
Guardian 2
Both
Other Caregiver

Where to send accounts

Guardian 1
Guardian 2
Both
Other Caregiver

Where to send correspondance/reports

Guardian 1
Guardian 2
Both
Other Caregiver

I/We agree that my son/daughter/ward shall be subject to the Codes of Conduct and Discipline of College House, to abide by the Hostel fees policy of the Board Of Trustees. *

First

Last

Date *

Comment

Students

After School programs

Staff

Years Established

Get In Touch

Location: Renall Street, Masterton

Telephone: 06 370 0415 or 027 285 2320

Email: office@waicolhostel.co.nz

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