STUDENT PERSONAL DETAILS
Family Name..........................................................
First name(s)..............................................................
Age....................... Male Female
Date of birth _____ day ______ month______ year
Nationality..........................................................
Home addres............................................................
....................................................................................
Home telephone:.......................................................
Fax................................................................................
Email...........................................................................
Do you have any disability or medical problem that you would like to advise the school of in order that we may best cater for your needs? YES / NO
If yes, please provide details:.........................................
.............................................................................................
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ENGLISH STUDY DETAILS
Please identify your first course preference and your second course preference from the list of courses:
Certificate in General English:
Circle your choices:
Beginners / Elementary / Pre-Intermediate / Intermediate /
Upper-Intermediate / Advanced
IELTS Preparation
Circle your choices:
Stage 1 / Stage 2
How many weeks do you wish to study..............................
When do you wish to start: _____ day ______ month______ year
Fulltime students must attend two class sessions per day. If you are not attending fulltime: state preferred sessions: Morning or afternoons Which English /IELTS level do you wish to achieve...........................
Note that enrolment and commencement on any course will be determined following an assessment of your prior learning by Edinburgh Institute.
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PREVIOUS SCHOOLING AND QUALIFICATIONS
Did you study English at High School Yes / No, Did you study English at University Yes / No
How many years of schooling have you completed in your home country? ___________
Name your highest High School qualification:.............................................................................
Name any university or tertiary qualifications:...................................................................................
Name any NZ school or college where you have previously studied:........................................................................................................
Name any NZ school or college where you are currently enrolled:..................................................................................................... |
ACCOMMODATION
Do you require Edinburgh to arrange hostel/ homestay accommodation for you? YES / NO. If yes, please complete our hostel or homestay application form.
If you have arranged your own accommodation in NZ and it is different from your home address provided above, please provide contact details:
Address:............................................................................................................................................................................................
Phone number:......................................................................................................
Do you wish to be met at the airport by a representative of Edinburgh Institute: YES / NO / Not applicable |
Please provide contact details of the person (e.g. your parents) that the school may contact in the event of an emergency or if there is serious concern regarding your welfare whilst at our school.
Family Name........................................................... First name(s)........................................................................
Relationship to you: Mother Father Other If Other please states details:...............................................
Home address.........................................................................................................................................................................
.........................................................................................................................................................................................................
Home telephone:............................................................ Business telephone...................................................................
Mobile phone...................................................... Relationship of this person to you: ..............................................
I also request progress reports and details of any disciplinary action to be sent to my parents at the above address. YES / NO |
DECLARATION BY APPLICANT
1. The information provided by me is correct and I am at least 18 years old.
2. I understand and accept the published enrolment and payment policies of the Institute.
3. I understand and accept the withdrawal and refund policies of the Institute.
4. I understand and agree to come to all classes on time and behave in a responsible way at school and in the hostel or homestay and according to the published rules of Edinburgh Institute.
5. I understand and accept that if I am an international student I have been informed that I must have travel and medical insurance. I accept that if I do not have evidence of my medical insurance on enrolment, I will be required to purchase medical insurance.
6. I understand that New Zealand Immigration Services may require me to obtain a Student Visa and Student Permit if I wish to study in New Zealand for longer than 3 months. I also understand and accept that once I arrive in New Zealand I must provide to Edinburgh Institute my address and contact details for where I am staying in New Zealand and I must provide my passport for the purpose of photocopying my Student Permit and any renewal. If I change my address or contact phone number whilst enrolled at Edinburgh Institute I will immediately provide that information to the Administrator of Edinburgh Institute.
7. I understand that the information collected by the Institute during the enrolment process and while I am studying at the Institute will be used for my education and well being and will only be released to authorised persons within the Institute or as required by law. I have right of access to and correction of the personal information held by the Institute including my attendance and academic records.
8. I understand and accept that the Institute has the right to decide my level of study based on the professional judgement of the Director of Studies giving regard to what is in my best interest.
9. I understand and accept that the above terms and conditions are intended to be read in the English language and are governed by the laws of New Zealand.
Signature of applicant:........................................................ Date:................................................. |
| ORIGINAL DOCUMENTS TO BE PROVIDED BY APPLICANT FOR PHOTOCOPYING BY AGENT OR EI ADMINISTRATOR |
| STUDENT DOCUMENTS |
Agent to complete |
Date Received from Agent by EI |
Signature of EI Administrator |
| Evidence of my most recent IELTS test results |
YES / NO |
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| Evidence of my highest qualifications or most recent school report |
YES / NO |
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| My passport or evidence of age |
YES / NO |
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Name of agent: Agents stamp:
Date of signing: |
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