PART ONE
Note: It is important that you include all relevant information about the student in your application. This information is used to ensure that the student is supported properly upon arrival and to match them with suitable homestays, teachers and courses. Where information is included relating to health issues or learning needs, disclosure of this information will not automatically disqualify the Student from Enrolment. However, failure to disclose information or providing misleading information may result in the withdrawal of an Offer of Place or termination of a Contract of Enrolment.
Student Details
Name must be as it appears on your passport
Name
First Name
Last Name
Preferred Name
Date of Birth
-
Month
-
Day
Year
Date
Gender
Male
Female
Primary Spoken Language
Country of Citizenship
Passport Number
Passport Expiry Date
-
Month
-
Day
Year
Date
Email Address
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Intended Start Date
-
Month
-
Day
Year
Date
Intended End Date
-
Month
-
Day
Year
Date
Applying for year level:
Please Select
Year 7
Year 8
Year 9
Year 10
Year 11
Year 12
Year 13
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Parent One or Legal Guardian:
NOTE: It is requirement of New Zealand regulations that schools must maintain effective communication with parents and legal guardians. To comply with the requirements, contact information provided in this section MUST be the contact information for the parents or legal guardian.
Full Name
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Pr.
Others
Title (Mrs./Ms./Mr./Dr.)
First Name
Last Name
Relationship to Student
Mother/Father/Aunt/Grandparent/Caregiver
Address (Leave blank address same as student's.)
Home Address
Postal
Contact Info:
Home Phone:
Mobile Phone:
Email:
Primary Spoken Language
Country of Citizenship
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Parent Two or Legal Guardian:
NOTE: It is requirement of New Zealand regulations that schools must maintain effective communication with parents and legal guardians. To comply with the requirements, contact information provided in this section MUST be the contact information for the parents or legal guardian.
Full Name
Title (Mrs./Ms./Mr./Dr.)
First Name
Last Name
Relationship to Student
Mother/Father/Aunt/Grandparent/Caregiver
Address (Leave blank address same as student's.)
Home Address
Postal
Contact Info:
Home Phone:
Mobile Phone:
Email:
Primary Spoken Language
Country of Citizenship
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Religious Details
Denomination (Religion):
Church of membership:
Please Select
Dedicated
Baptised
Christened
Confirmed
Not affiliated
Church of membership address & phone number:
Church Address
Phone Number (include country code)
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Other Contacts
Emergency Contact (In home country, other than parents):
Contact's Full Name
Relationship to the student:
Contacts
Mobile Phone
Home Phone
Email
Agent
If using an agent
Agency Name
Agent's Full Name
Email:
Contact Number:
Submit
Should be Empty: