English Language School by the Sea Napier, New Zealand.
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Enrolment Procedure
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Application Form
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Are you a:*
Student
Education/Travel Agent
Education/Travel Agent Details:
What is your full name?
What is your company name?
What is your email address?
Student Details:
Family Name*
First Name(s)*
Gender*
Male
Female
Address*
Country*
Telephone
Email address*
Date of Birth*
DD/MM/YYYY
Start Date*
Finish Date*
Number of Weeks*
Course Type*
Full time
Part time morning
Part time afternoon
Level*
Beginner
Elementary
Pre-Intermediate
Intermediate
Upper-Intermediate
Advanced
Do you need insurance?*
Yes
No
Do you need a homestay?*
Yes
No
If 'Yes'
Homestay type
Young children (0 - 10 years)
Older children ( 11 - 18 years)
No children
Would you stay with a student from another country?
Yes
No
I don't mind
Do you smoke?
Yes
No
Do you have any health problems or allergies?*
Yes
No
If 'Yes'
Please specify:
I have read the Enrolment Conditions*
Yes
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