Application Form
For Canterbury New Initiative
First Name of Child *
Your answer
Family Name of Child *
Your answer
Gender of Child *
Current Age of Child *
Your answer
Date of Birth
MM
/
DD
/
YYYY
Country of Birth *
Your answer
Preferred start date
MM
/
DD
/
YYYY
Has your child attended any of the following *
Required
What is your child's ethnic background *
Your answer
What is your child's first language *
Your answer
Does your child speak any additional languages *
Your answer
Has your child had any assessments regarding additional needs *
Your answer
Does you child suffer from any of the following *
Required
Does your child have any allergies or dietary requirements? *
Does your child have any siblings? If so, what age are they? *
Your answer
Describe the child's living arrangement if other than living with two parents
Your answer
Number of parents / carers *
Full Name of Parent 1 *
Your answer
Address of Parent 1 *
Your answer
Email of Parent 1 *
Your answer
Telephone Number of Parent 1 *
Your answer
Occupation *
Your answer
Relationship to the child *
Your answer
Full Name of Parent 2 *
Your answer
Address of Parent 2 *
Your answer
Email of Parent 2
Your answer
Telephone Number of Parent 2
Your answer
Occupation
Your answer
Relationship to the child
Your answer
How did you hear about the Canterbury New Initiative *
Your answer
What is it that attracts you this education
Your answer
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