Enrolment Form

Fill out and click send, or print-out and fax to +64 9 302 5299

* indicates a compulsory field that must be filled in

Who is making this booking?

Student:
Agent:

Personal Details

Family Name: *
Given Names: *
Date of Birth: *
Sex: *	Male Female
Nationality: *
Address: *
City: *
Country: *
Telephone: *
Fax:
Email: *

Course Details

Accommodation Details *

I will find my own accommodation
I wish to stay with a host family
I wish to stay at the school apartments (note for Combo enrolment: Napier has no student apartments)

Single/Semi-single Apartment
Shared Apartment

Accommodation required:

From:
To:
For: weeks

What kind of Homestay do you want?
We will do our best to meet your requests.
Family with children Family with no children

Do you smoke?
Yes No

Can you eat most foods?
Yes No

Please tell us foods you CANNOT eat...

Do you have any health problems or allergies?
Yes No

If YES, what are they?

Medical Insurance *

Do you want us to arrange medical insurance for your stay in NZ? Medical Insurance is required. Information about Insurance in New Zealand can be found on the website http://www.uni-care.org

Yes, please arrange for me and add to invoice.
No, I will arrange myself and send proof.

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If you are unable to send this enrolment form, please send your details directly by email to info@worldwideschoolofenglish.com

How many weeks do you wish to study for? (min 1 week, max 48 weeks) *
Start Date: *
General English *	Full Time/Intensive Part Time: Morning Part Time: Afternoon
What other classes are you interested in?
Exam Preparation	IELTS TOEIC Cambridge FCE or CAE TESOL + TKT
Business English
English + Plus
Combo Programme (study at 2 or more Combo schools)	(# of weeks)
What other Combo Schools do you want to study at?	Napier (# of weeks) Christchurch (# of weeks) Queenstown (# of weeks)