Registration Process

If you are ready to submit a Registration Application, you can do it online with the form below, or you can open the PDF file link to print and post it to us.

Payment for the Initial Application Fee and diagnostic tests can be by cheque or internet banking.
Contact henz@homeductionnz.co.nz for bank account details if you wish to pay via internet banking.

Registration Form

 

Family Surname (required)

Father’s Name

Father’s Title:

Mother’s Name

Mother’s Title:

Address: including Suburb and City

Postal Code

Your Email Address (required)

Home Phone:

Work Phone:

Mobile Phone(s): (both caregiver's mobile numbers if applicable - put a name beside each number)

Fax:

Have you done the training?

Have you got Homeschool Exemptions for the children?

Do you want to do diagnostic tests online?

CHILD ONE

Full Name: (including middle names) Include Surname if different from Family Surname.

Gender:

Age:

Date of Birth: (use dd/mm/yyyy format)

Completed Diagnostic Tests?

Currently Attending:

Any comments about special needs or any learning difficulties.

CHILD TWO

Full Name: (including middle names) Include Surname if different from Family Surname.

Gender:

Age:

Date of Birth: (use dd/mm/yyyy format)

Completed Diagnostic Tests?

Currently Attending:

Any comments about special needs or any learning difficulties.

CHILD THREE

Full Name: (including middle names) Include Surname if different from Family Surname.

Gender:

Age:

Date of Birth: (use dd/mm/yyyy format)

Completed Diagnostic Tests?

Currently Attending:

Any comments about special needs or any learning difficulties.

CHILD FOUR

Full Name: (including middle names) Include Surname if different from Family Surname.

Gender:

Age:

Date of Birth: (use dd/mm/yyyy format)

Completed Diagnostic Tests?

Currently Attending:

Any comments about special needs or any learning difficulties.