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Personal Details:

Family Name: *

First Name: *

Preferred Name:

Date of Birth: *

Gender: *

Address: *

Telephone: *

Mobile Phone:

Nationality: *

Passport Number:

Email Address: *

Agent:

You must inform us immediately if you change your address while studying at the Bay of Plenty English Language School.

Emergency contact name and number in own country: *

Upload the latest report on your child from his/her school (optional).

Does your child have a history of behavioural and/or learning problems.

Course Details:

Please tick the courses/exams you with to apply for:

General English:

Preparation for the IELTS exam:

Preparation for the TOEIC exam:

There are no minimum entry requirements.

Proposed start date:

Finish date:

Total weeks:

My aims in studying English are:

How did you hear about us?

Accommodation:

Homestay Information: You will stay in a typical New Zealand Homestay, where you will have your own separate bedroom and be provided with three meals a day.

I require Homestay:

I am a smoker:

Most families in New Zealand have cats/dogs as pets in their homes.

Are you allergic to any pet animals?

Do you want to stay in a home where there are young children?

Do you want to stay in a home where there are adult children?

Do you have a medical condition you need treatment for?

If yes, please state:

What are your favourite foods?

Are there any foods that you cannot eat?

If yes, please state:

Do you have any religious requirements?

If yes, please state:

Do you play a musical instrument?

If yes, please state:

Do you play a sport?

If yes, please state:

Do you have any brothers?

Do you have any sisters?

What are your interest/ hobbies?

CODE: Bay of Plenty English Language school has agreed to observe and be bound by the Code of Pastoral Care of International Students published by the Minister of Education. Copies are available on request from this institution or from the New Zealand Ministry of Education at www.minedu.govt.nz.

Health and Travel Insurance*

Eligibility for Health Services: Most students are not entitled to publicly funded health services while in New Zealand. If you receive medical treatment during your visit, you may be liable for the full costs of that treatment. Full details on entitlements to publicly-funded health services are available through the Ministry of Health, and can be viewed on their website at www.moh.govt.nz.

Accident Insurance: The Accident Compensation Corporation provides accident insurance for all New Zealand citizens, residents and temporary visitors to New Zealand, but you may still be liable for all other medical and related costs. Further information can be viewed on the ACC website at www.acc.co.nz.

Medical and Travel Insurance: International students must have the appropriate and current medical and travel insurance while studying in New Zealand. For up to date minimum requirements for travel and medical insurance, please go to Unicare’s website www.uni-care.org.

I have medical and travel insurance.

OR

I have not yet taken out medical and travel insurance, but agree to do so and will provide proof of this to the school on acceptance of this application for enrolment.

OR

I would like the school to arrange medical and travel insurance on my behalf and bill me for this together with school fees.

If you have travel and medical insurance, please provide your details:

Insurance company:

Policy type:

Policy start date:

Policy end date:

Immigration:

Full details of visa and permit requirements, advice on rights to employment in New Zealand while studying, and reporting requirements are available through the New Zealand Immigration Service, and can be viewed on their website at www.immigration.govt.nz.

Travel to Tauranga:

A shuttle bus meets passengers at the Auckland Airport and transports them to Tauranga.

Buses leave from Auckland City Centre and cost from $30. An extra $10 + bus fee is required to get from the Airport to the City Centre. You would need to make your own bus bookings.

I would like to arrange for a private vehicle transfer service ($345).

I would like you to arrange travel for me from Auckland by shuttle to Tauranga ($95).

I will make my own arrangements to travel to Tauranga.

Please read the Conditions of Enrolment here.

I confirm I have read and agree to the Conditions of Enrolment. *

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