International Student Enrolment Application Form

 

Student details
Family name:
First name:
Preferred name:
Date of birth:

(date/month/year)

Nationality

(as shown in passport):

Passport number:Passport expiry:
Visa type/status:
Date of first entry into New Zealand:
Address (in home country):
Phone (in home country):

 

Details of parent/legal guardian enrolling student
Family name:
First name:
Preferred name:
Date of birth:

(date/month/year)

Nationality

(as shown in passport):

Passport number:Passport expiry:
Address (in home country):□ Tick if same as student or enter below
Home phone:Cell phone:
Email:
Enrolment
Length of enrolment:
Insurance
Your child must have medical and travel insurance to cover the period of study, from leaving home to returning home. Please provide copies of these insurance policies in English.

 

Health
Vaccinations (please list OR provide a vaccination certificate in English):Date received:
Has the student had a Tetanus injection in the last 5 years?YesNo
Has the student been in contact with any contagious diseases within the last 3 months?YesNo
If yes, please give details:
Medical conditions (please list):Enter any medication required:
Allergies (please describe):Enter any medication required:
Does the student suffer from any disability?

If yes, please give details:

YesNo

ACCOMMODATION

Students under 10 years old
Students under 10 years of age must live with a parent or legal guardian, or in an approved school hostel.
My child will be living with me (parent/legal guardian).Signed:
Students 10–17 years old
Students aged 10–17 years must live with a parent or legal guardian, or a residential caregiver.
My child will be living with me (parent/legal guardian).Yes/No
My child will be living with a designated caregiver (relative or close family friend designated in writing by me, the parent/legal guardian)Yes/No
My child will be living with a homestay caregiver.Yes/No

 

Group students
Group students under 10 years of age must live with a parent or legal guardian, or in an approved school hostel.

 

Parent/legal guardian living with student in New Zealand
Family name:
First name:
Preferred name:
Date of birth:

(date/month/year)

Nationality

(as shown in passport):

Passport number:Passport expiry:
Visa type/status:
Date of first entry into New Zealand:
Address (in home country):□ Tick if same as student or enter below
Home phone (in home country):Cell phone:
Email:
Address (in New Zealand):

This is the address where you and the student will be living.

Home phone (in New Zealand):Cell phone:
Designated caregiver living with student in New Zealand
Relationship to student:
Family name:
First name:
Preferred name:
Is the designated caregiver a New Zealand citizen or resident?
□ Yes  (keep answering from “email” below)   □ No (if no, please complete details below)
Date of birth:

(date/month/year)

Nationality

(as shown in passport):

Passport number:Passport expiry:
Visa type/status:
Date of first entry into New Zealand:
Address (in home country):
Home phone (in home country):Cell phone:
Email:
Address (in New Zealand):

This is the address where the designated caregiver and the student will be living.

Home phone (in New Zealand):Cell phone:

ABOUT THE STUDENT

General information
Briefly tell us about your aspirations for your child while they live in New Zealand, e.g. reasons for coming to New Zealand.
Briefly, tell us about your child’s interests e.g. sports, cultural, music.
Briefly tell us what your child enjoys most when at school e.g favourite classes, activities in class.
Education
Does your child have any special learning needs?□ Yes (if yes, please describe below)   □ No
Previous school(s) in New Zealand (please answer if applicable)
School name:Dates enrolled/attended:

 

DECLARATIONS

Please read these statements carefully and ensure you understand them.
I have been informed about and received a summary of the Code of Practice for International Students.YesNo
I have received a copy of the school’s Guide for International Students.YesNo
I understand the costs involved with enrolment, and the school’s policy regarding fee refunds and protection.YesNo

I confirm all the information contained in this enrolment application is true and correct to the best of my knowledge.

I acknowledge that if I have provided false information or withheld relevant information, the school may terminate the enrolment.

I will inform the school if there are any changes to the details of this application.

Parent/legal guardian name:

_________________________________________________

Parent/legal guardian signature:

_________________________________________________

Date: ____________________________________________

 

Parent/legal guardian name:

_________________________________________________

Parent/legal guardian signature:

_________________________________________________

Date: ____________________________________________

 

DOCUMENTATION

Please provide the following documents (copies or originals) with this application:
Student’s passport and visa details
Passport of person who will be living with the student and visa details
Designated caregiver agreement
Immunisation certificate (in English) for student
Tuition Agreement
Evidence of medical and travel insurance
EOTC consent form
Digital Citizen Responsible Use Agreement