International Student Application Form

English Teaching College

International Student Application Form

Personal Details of Student

Family Name:
First Name(s):

Date of Birth: ___ / ___ / ___ Age: Gender: Male Female

Present Citizenship or Nationality: Present Occupation:
Passport Number: Passport Expiry Date:
First Language: Other Languages:

Home Address in New Zealand (if known) Address in Home Country

Phone Phone

Mobile Mobile

Email Email

Students must notify ETC when they change their address.
Please provide ETC with parents’ e-mail and phone number if students are under 18.

English Level

Beginner Elementary Pre-Intermediate (Able to write and spell to reasonable standard)
Lower-Intermediate (Equivalent to IELTS 4.5) Intermediate (Equivalent to IELTS 5.5)
Upper-Intermediate (Equivalent to IELTS 6.0) Advanced (Equivalent to IELTS 6.5 or higher)

Have you sat any English tests? PTE FCE CAE TOEIC IELTS
If Yes: Please provide detail
(Score: W____ R____ L____ S_____ Overall ____)

Highest level of qualifications:
Year obtained:

Course Information Wellington Lower Hutt

Campus Site: Palmerston North

Course Name: Academic English IELTS Preparation FCE/CAE Preparation
General English Number of study Weeks:
High School Holiday Programme
TOEIC
Start Date: End Date: weeks

Application to study: Full time Part time morning Part time afternoon

What are your career plans after studying at ETC?

If you have studied in New Zealand, please supply your Academic Report & Attendance Record.

If you have a medical condition or disability, please supply details.
If the applicant is an agent please provide name and contact details.

Wellington Campus |TOEIC ETS Authorised Testing Centre | Level 2, 204 Willis Street |PO BOX 9787|Wellington 6141 | Phone: +64 4 385 0066|
Lower Hutt Campus | Level 3, 92 Queens Drive | Lower Hutt 5010 | Phone:+64 4 974 9984 | [email protected]

Palmerston North | 140-144 The Square | PO Box 995|Palmerston North 4410 | Phone: +64 6 357 7107||[email protected]| Head Office

Insurance: ETC will arrange your travel and health insurance

Insurance is compulsory for international students and include the fee in the invoice.

If you do not wish ETC to arrange this, please contact ETC before making alternative arrangements.

Accommodation Arrangement Note: Homestay accommodation is vetted and approved by ETC. Students

under the age of 18 years can only be in an ETC approved Homestay or in Code approved accommodation.

Would you like ETC to arrange your accommodation? Yes No

Start Date: End Date: Number of study weeks:

Accommodation Option:

Homestay Homestay on Farm (limited number)
Hotel /Motel/Hostel/Apartment
Note: ETC can make recommendation but does not guarantee suitability

1. Do you smoke?  Yes  No 3. Do you mind living in a house that has
2. Would you prefer living with a family that pets?  Yes  No
has (young) children?
5. Are there any foods that you cannot
 Yes  No
 Do not mind either way eat?  No

4. Do you have to follow any specific diet?  Yes/ please
No  Yes:  Vegetarian  Vegan
Other:_______________________________ specify:____________________
_
7. Do you suffer from any medical
6. Are you allergic to any foods or animals? condition?
 No  No
 Yes/ please  Yes/ please
specify:____________________ specify:____________________

8. Do you have any questions about your 9. Do you mind if other International
accommodation? Students live with the family?  Yes 
No

10. Interest and Hobbies:

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 http://www.immigration.govt.nz

English Teaching College (ETC) is the trading name for Education & Training Consultants New Zealand Ltd. Head office Box 995 Palmerston North
ETC is registered & approved by NZQA as a category 2 provider confident in education performance and confident in capability in self-assessment.

Wellington Campus |TOEIC ETS Authorised Testing Centre | Level 2, 204 Willis Street |PO BOX 9787|Wellington 6141 | Phone: +64 4 385 0066|
Lower Hutt Campus | Level 3, 92 Queens Drive | Lower Hutt 5010 | Phone:+64 4 974 9984 | [email protected]

Palmerston North | 140-144 The Square | PO Box 995|Palmerston North 4410 | Phone: +64 6 357 7107||[email protected]| Head Office