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APPLICATION FORM - 2025 ENTRY
Applications are open for students entering Year 9 in 2025 only
Date of Application
*
PART ONE: STUDENT INFORMATION
A. PARTICULARS OF STUDENT (RANGATAHI)
Student's name
*
First name
Last name
Which Kainga are you applying for?
*
Te Kainga Huarahi (Girls)
Te Kainga Wananga(Boys)
Student's home address
*
Address line 1
Address line 2
Address line 3
Address line 4
Town/Suburb
City
Postcode/Zip
Caregivers /Parents Home phone
Caregivers /Parents Mobile
Student's Date of Birth
*
Student's Country of Birth
*
Permanent Resident
*
No
Yes
Please provide Certified Signed Copy of Birth Certificate (see the checklist at end of form)
What school are you currently attending?
*
What year group are you currently in, in 2024?
Other
1. Year 7/Form 1
2. Year 8/Form 2
3. Year 9/Form 3
4. Year 10/Form 4
5. Year 11/Form 5
6. Year 12/Form 6
7. Year 13/Form 7
Alumni/Student Left
Current Principal/Head teacher we may contact (name, position, phone, email)
*
Please provide a copy of the latest School Report and two(2) other reports as well as a current reference letter from the Principal or a teacher. In the reference letter, we would like them to explain why they think the rangatahi would thrive at InZone and the school. (see checklist at end of form)
Please note - Applications are only being accepted for Year 9/Form 3 girls for Epsom Girls Grammar and Year 9/Form 3 boys for Auckland Grammar School.
What Year/Form will you be in 2025?
*
Year 9 / Form 3
Year 10 / Form 4
Year 11 / Form 5
Year 12 / Form 6
Year 13 / Form 7
MAORI/PACIFIC WHAKAPAPA:
Iwi, Motu or Island you identify with
*
Ahuriri Hapū
Cook Islands
Fiji
Heretaunga Tamatea
Maniapoto
Maraeroa A & B
Maungaharuru Tangitū Hapū
Mōkai Pātea Nui Tonu
Moriori
Muaūpoko
Ngā Mahanga
Ngā Rauru Kītahi
Ngāi Tahu
Ngāi Tai ki Tāmaki
Ngāi Takoto
Ngāi Tāmanuhiri
Ngāi Te Rangi
Ngāitai (Bay Of Plenty)
Ngāpuhi
Ngāpuhi / Ngāti Kahu ki Whaingaroa
Ngāruahine
Ngāti Apa
Ngāti Apa ki te Rā Tō
Ngāti Awa
Ngāti Hako
Ngāti Hauā
Ngāti Hāua (Upper Whanganui)
Ngāti Hauiti
Ngāti Hei
Ngāti Hine
Ngāti Hinerangi
Ngāti Hineuru
Ngāti Kahu
Ngāti Kahu ki Whangaroa
Ngāti Kahungunu
Ngāti Kahungunu ki Wairarapa - Tāmaki Nui ā R
Ngāti Kea / Ngāti Tuarā
Ngāti Kōata
Ngāti Korokī Kahukura
Ngāti Kuia
Ngāti Kurī
Ngāti Mākino
Ngāti Manaia
Ngāti Manawa
Ngāti Manuhiri
Ngāti Maru (Hauraki)
Ngāti Maru (Taranaki)
Ngāti Mutunga
Ngāti Mutunga o Wharekauri (Chatham Islands)
Ngāti Pāhauwera
Ngāti Paoa
Ngāti Pikiao
Ngāti Porou
Ngāti Porou ki Harataunga ki Mataora
Ngāti Pūkenga
Ngāti Pūkenga ki Waiau
Ngāti Rāhiri Tumutumu
Ngāti Rangi
Ngāti Ranginui
Ngāti Rangiteaorere
Ngāti Rangitihi
Ngāti Rangiwewehi
Ngāti Rārua
Ngāti Raukawa
Ngāti Raukawa ki te Tonga
Ngāti Rehua
Ngati Rongomaiwahine
Ngāti Ruanui
Ngāti Ruapani ki Waikaremoana
Ngāti Tahu / Ngāti Whaoa
Ngāti Tama
Ngāti Tama ki Te Tau Ihu
Ngāti Tamaoho
Ngāti Tamaterā
Ngāti Tara Tokanui
Ngāti Tarāwhai
Ngāti Te Ata
Ngāti Toa Rangatira
Ngāti Tūrangitukua
Ngāti Tūwharetoa
Ngāti Tūwharetoa (Bay of Plenty)
Ngāti Uepohatu
Ngāti Whanaunga
Ngāti Whare
Ngāti Whātua
Ngāti Whātua o Kaipara
Ngāti Whātua o Ōrākei
Ngātiwai
Niue
Not Stated
Pouākani
Rangitaiki
Rangitāne
Rangitāne o Wairau
Raukawa
Rongowhakaata
Samoa
Tainui
Tapuika
Taranaki
Taranaki Whānui ki te Upoko o te Ika
Te Aitanga ā Māhaki
Te Ākitai Waiohua
Te Arawa
Te Atiawa (Taranaki)
Te Atiawa (Wellington)
Te Atiawa ki Whakarongotai
Te Atiawa o Te Waka-a-Māui
Te Atihaunui a Papārangi
Te Aupōuri
Te Kawerau a Maki
Te Korowai o Wainuiārua (Central Whanganui)
Te Patukirikiri
Te Rarawa
Te Roroa
Te Taou
Te Ure o Uenukukōpako / Ngāti Whakaue
Te Uri o Hau
Te Waiariki
Te Wairoa iwi and hapu
Te Whānau a Apanui
Tonga
Tūhoe
Tūhourangi
Waikato
Waitaha
Whakatōhea
Whanganui Iwi / Te Atihaunui a Pāpārangi
Whanganui Land Settlement (Lower Whanganui)
Ethnicity (Select one)
*
Australian
Bangladesh
Cambodian
Chinese
Cook Island Maori
Croatian
English
Fijian
Fijian Indian
Filipino
German
Indian
Irish
Japanese
Korean
Latin American
Maori
Middle Eastern
Niuean
NZ European
Other (please specify below)
Other Asian (please specify below)
Other European (please specify below)
Other Pacific Peoples (please specify below)
Pacifica general (Island not stated)
Samoan
Scottish
Tokelauan
Tongan
Other Ethnicities - You may select more than one
*
Australian
Bangladesh
Cambodian
Chinese
Cook Island Maori
Croatian
English
Fijian
Fijian Indian
Filipino
German
Indian
Irish
Japanese
Korean
Latin American
Maori
Middle Eastern
Niuean
NZ European
Other (please specify below)
Other Asian (please specify below)
Other European (please specify below)
Other Pacific Peoples (please specify below)
Pacifica general (Island not stated)
Samoan
Scottish
Tokelauan
Tongan
What is the religion of your whānau?
*
Do you practice your religion?
B. RANGATAHI INTERESTS AND ACHIEVEMENTS
Please provide information about the student's/rangatahi;
Sport Activities and/or interests/ 1 summer or 1 winter sport activity
*
Music and Art Activities and/or interests
*
Cultural Activities and/or interests ie Kapa haka. Participation in kapa haka and/or Polynesian groups is an expectation
*
C. RANGATAHI HEALTH & SAFETY STATEMENT (This information is for use by InZone Education) Failure to disclose such information truthfully can jeopardize your rangatahi's place in the kāinga.
Does your student/rangatahi:
Have a condition that may affect learning, eg impaired sight, hearing or motor skills, ADHD, dyslexia etc.. Please explain
*
Have any other health problems? Please explain
*
Require regular medications? Please explain
*
Challenged by any mental health conditions such as anxiety, depression, past trauma etc... Please explain or note that you would like to discuss this further in person.
*
Have any special dietary requirements? Please explain
*
Have any allergies? Please explain
*
Vaccinations general
All students should have completed their childhood Immunisation Programme before commencing secondary school.
Please provide copy of Immunisation Records (see checklist at end of form)
Has the student had involvement in any other of the following agencies
*
Oranga Tamariki
Police/ Youth aid
Specialist Education Services (incl RTLB, SENCO etc.)
Other Counselling/Psychological Services
Any other agency involvement (please explain below)
No
If you ticked any of the above, please explain the nature of any involvement
Please provide any reports from agencies/professionals that have had/are having involvement with your student/rangatahi (see checklist at end of form)
Is there anything else you would like to tells us about your child's health
D. STUDENT STATEMENT
We would like to get to know your student/rangatahi. We expect a full A4 sheet to be filled (in his/her own handwriting) explaining why he/she believe InZone and the school would be beneficial for him/her, and highlighting the strengths he/she believe would bring to the kāinga and the school. (see checklist at end of form)
E. Ministry of Education Boarding Allowance
Are you applying for Ministry of Education (MoE) Boarding allowance?
*
Yes
No
PART TWO - PARENTS/GUARDIANS & WHANAU INFORMATION
A. PARTICULARS OF PARENTS/CAREGIVERS WHO LIVE AT SAME ADDRESS AS RANGATAHI
Parent/Caregiver at same address
*
First name
Last name
Relationship with Student
*
Aunt
Brother
Father
Grandfather
Grandmother
Guardian
Half Brother
Half Sister
Mother
Other
Sister
Step Brother
Step Sister
Step-Father
Step-Mother
Uncle
Email address
*
Please note that yahoo emails aren't compatible with our system. Please provide an alternative email.
Mobile
*
Other phone
Name of Employer & Occupation
*
Type of employment
*
Unemployed
Fulltime
Part-time
Casual
Contract
Self-employed
How Parents/Carers can help InZone. Please choose one or more
*
In order to keep fees down, it is crucial we create a hub of volunteers amongst whanau working together with us. Please tick how you may be able to help out
Cooking
Fundraising
Kapa haka and/or cultural activities
Other
Supervision on field trips, sports activities or outings
Tutoring
Weekend staff relief
+ Add another
- Remove
B. PARTICULARS OF PARENTS/CAREGIVERS WHO LIVE AT DIFFERENT ADDRESS TO RANGATAHI
Parent/Caregiver at different address
First name
Last name
Relationship with Student
Aunt
Brother
Father
Grandfather
Grandmother
Guardian
Half Brother
Half Sister
Mother
Other
Sister
Step Brother
Step Sister
Step-Father
Step-Mother
Uncle
Address
Email address
Please note that yahoo emails aren't compatible with our system. Please provide an alternative email.
Mobile
Other phone
Name of Employer & Occupation
Type of employment
*
Unemployed
Fulltime
Part-time
Casual
Contract
Self-employed
How Parents/Caregivers can help InZone. Please choose one or more
In order to keep fees down, it is crucial we create a hub of volunteers amongst whanau working together with us. Please tick how you may be able to help out
Cooking
Fundraising
Kapa haka and/or cultural activities
Other
Supervision on field trips, sports activities or outings
Tutoring
Weekend staff relief
Are there any current Parenting Orders or Child Custody Arrangements?
If Yes, please provide copies of any orders/arrangements (see checklist at end of form)
+ Add another
- Remove
C. SIBLINGS OF THE APPLICANT (Please include any whangai siblings or other dependent children not living with the applicant)
Brother/sister's name
First name
Last name
Gender
Female
Male
Date of Birth
+ Add another
- Remove
D. FINANCIAL INFORMATION OF PARENTS/CAREGIVERS
Total Annual Household Income (salary/wages &/or any MSD payments) of the Parent/Caregiver (& Spouse/Partner if applicable) BEFORE tax & any other deductions
*
1. Under $45,000
2. $45,000-$60,000
3. $60,000-$80,000
4. $80,000-$100,000
5. $100,000-$120,000
6. $120,000 or more
Do you forsee any financial challenges in the next 12 months?
*
Yes
No
Potentially
E. RESIDENCE OF THE PARENTS/CAREGIVERS
What residence do you occupy?
*
Own Home
Renting
Boarding
Other
If you selected "other", please explain
How long have you lived at the above address (years & months)
How far is your residence from InZone (in kms)
F. PARENTS/CAREGIVERS STATEMENT
As a parent/caregiver, please list your reasons for wishing your student/rangatahi to be a part of InZone. Please write on a separate sheet and send with all other required documents (see checklist at end of form). Also, if you wish to attach a more detailed statement in answer to some of the questions above, please do so here
G. PARENTS/CAREGIVERS INVOLVEMENT WITH INZONE
Is there another way you would like to be involved in helping InZone?
H. PARENTS/CAREGIVER GENERAL
What is the highest level of education of
Mother/Caregiver
*
Father/Caregiver
*
Please tell us how you heard about us
*
Whānau
Friend
Advertisement
Internet
School
Other
If you selected "other" please explain
I. EMERGENCY DETAILS (Not Parents or Caregivers) -
Your emergency contact person must reside within a 30 kilometer radius of InZone AND must be available to care for the student in the event of illness or an emergency
Name, Email, Phone & Address
*
Relationship to Applicant
*
PART THREE - DECLARATION AND PRIVACY ACT
DECLARATION - It is important that accurate information is given to ensure best practice in the care of the student. InZone reserves the right to reconsider rangatahi placement if details are inaccurate or incorrect or misleading information is provided.
I/we declare that the information provided in this application is true and correct.
I/we agree to notify InZone as soon as reasonably practicable of any change to the information contained in this application
I/we understand that acceptance of this form does not constitute admission of our student/rangatahi to InZone and that the selection of students for admission to InZone is at the discretion of InZone.
I/we understand should an offer be made that we will be required to enter into a written agreement with InZone
PRIVACY ACT - The information in this application form and collected by InZone during the application process and during the period in which the rangatahi is enrolled at InZone is intended for use in connection with assessing the suitability of the applicant (including sharing the application with Auckland Grammar School/Epsom Girls Grammar School as part of the application process) and the subsequent provision of boarding accommodation and wellbeing of the rangatahi during their time at InZone. InZone has as its primary purpose the provision of boarding accommodation, wellbeing and education of rangatahi and shall obtain such information as necessary to achieve this purpose and facilitate the operations and activities of InZone. The information collected may be used by any of the staff at InZone, consultants to InZone, existing and potential partners and services providers of InZone for these purposes.
I/we agree that InZone can obtain information about me/us from, and provide information about me/us to, other organisations or people it considers appropriate (including organisations that partner with InZone) for these purposes.
I/we understand and agree to the personal information provided in this form, and as collected above from other organisations, being used and disclosed for these purposes.
I/we agree that InZone may exchange information about me/us with credit reporting agencies on an ongoing basis. Those agencies may retain that information and provide it to other customers who use their credit reporting services.
I/we understand that I/we have the right to request access and request correction of any personal information.
I/we understand that InZone will follow the Information Privacy Principles in the Privacy Act 2020 relating to the collection, storage, use and disclosure of personal information.
CHECKLIST
Please note the following -
The address for all return mail will be the "student residential address"
The address given should be the student's usual home address. If the student spends lengthy periods at another address, then that address should be noted
Please check and tick that you have
Paid $100 administration fee (non-refundable) to our account no. 12-3198-0066948-000 - Reference:[Rangatahi's name]
Particular: '2025 Apply'
; Reference: [Rangatahi's first name and the first letter of their last name]
Completed all details in the online application form
Please check and tick that you have sent to InZone the following documents:-
Certified copy of Birth Certificate
Latest School Report and two(2) other school reports
Immunisation Records
Any Agency Reports
Student Statement (in his/her own handwriting).We expect a full A4 sheet to be filled, explaining why he/she believe InZone and the school would be beneficial for him/her, and highlighting the strengths he/she would bring to the kāinga and the school
Current Principal or teacher's reference letter explaining why they think the rangatahi would thrive at InZone and the school
Any Parenting orders/Caregiver arrangements
Parent/Caregiver Statement
PLEASE NOTE INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED
All correspondence should be sent to:
info@inzoneeducation.org.nz
alternatively, you can post to
Admissions
InZone Education Foundation
99 Owens Road
Epsom, Auckland 1023
Please check the highlighted fields
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