+64 7 577 1970
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Step 1 of 8 12% PERSONAL DETAILSFamily Name*First Name*Preferred name. What would you like to be called?Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender*MaleFemaleHow did you hear about the Bay of Plenty English Language School? (Please select from the dropdown)*Please selectAgentWebsiteFriendBrochureOtherAddress in New Zealand Street Address Address Line 2 City Telephone in New ZealandMobile PhoneAddress in Home Country* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Telephone in Home Country*Nationality*Passport NumberEmail Address* AgentEmergency Contact Name*Someone from your CountryEmergency Contact Phone*Latest School ReportAccepted file types: jpg, pdf, doc, docx. Medical DetailsDo you have any health problems or allergies?*YesNoPlease Detail*Are you taking any prescription medication?*YesNoPlease Detail*Do you have any learning or behavioural problems?*YesNoPlease Detail* COURSE DETAILSCourse* General English - Full Time General English - Part Time ( mornings only ) General English - Part Time ( afternoons only ) Preparation for the IELTS exam Proposed Start Date*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Finish Date*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Number of weeksFor example, type 1 -50 weeks.My aims in studying English are: ACCOMMODATIONDo you require Homestay?*YesNoA typical New Zealand Homestay is where you will have your own separate bedroom and be provided with three meals a day.First night at the homestayDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Last night at the homestayDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Are you smoker?*YesNoDo you have any health problems?*YesNoIf so, what are they?*What type of family would you like?*No childrenYoung childrenTeenagersI don't mindDo you like animals?*YesNoWhat type of animals?*What are your favourite foods?*What food don't you like to eat?*What is your religion?*What type of music do you like?*What are your interests / hobbies?*What languages do you speak?*Do you any special requests? HEALTH & TRAVEL INSURANCEEligibility 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.nzAccident 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.orgSelect*I have medical and travel insuranceI 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.I would like the school to arrange medical and travel insurance on my behalf and bill me for this together with school fees.Insurance CompanyPolicy TypePolicy Start DateDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Policy End DateDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 IMMIGRATIONFull 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.nzSelect*I have the required Visa alreadyI have not yet obtained the required Visa, but agree to do so and will provide proof of this to the school on acceptance of this application for enrolment.Issue DateDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Visa Number TRAVEL TO TAURANGAA shuttle bus can be arranged for you. Alternatively, you can take a bus from Auckland City Centre for the cost of approximately $30. An extra $16 bus fee is required to get from the Airport to Auckland City Centre. You would need to make your own bus bookings. Please note that if your flight arrives or departs on a New Zealand Statutory holiday, then the bus company will add a 20% surcharge to the fare.’Select*I would like you to arrange shuttle transport from Auckland Airport to Tauranga ($110)I would like you to arrange shuttle transport from Tauranga to Auckland (110)I would like you to arrange a private vehicle transfer service ($345)I will make my own arrangements to travel to Tauranga. CONDITIONS & CONFIRMATION* I confirm I have read and agree to the Conditions of Enrolment and Early Withdrawal and Refund Requirement. * 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. * I have not yet obtained the required Visa, but agree to do so and will provide proof of this to the school on acceptance of this application for enrolment. 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 Qualification Authority at www.minedu.govt.nzNameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle AJAX powered Gravity Forms.
