Bethlehem College
International Student Application Form
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Information Required
Note: It is important that you include all relevant information about the student in your application. This information is used to ensure that the student is supported properly upon arrival and to match them with suitable homestays, teachers and courses. Where information is included relating to health issues or learning needs, disclosure of this information will not automatically disqualify the Student from Enrolment. However, failure to disclose information or providing misleading information may result in the withdrawal of an Offer of Place or termination of a Contract of Enrolment.
Please make sure you have scanned copies of the following documents ready to upload before you begin:
- your current passport (if available)
- your photo (portrait photo, passport photo or similar)
- your last school report (translated into English)
- vaccination certificate (if available and must be in English)
- insurance certificate (if available and must be in English)
Please note: Fields marked with
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are required and must be completedTHIS APPLICATION MUST BE COMPLETED IN ENGLISH
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Agency Information
(if using an agent)
Agency name
Agent name
Agent email address
Student Details
First name (Name must be as it appears on your passport)
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Middle names (must be as it appears on your passport)
Family name (must be as it appears on your passport)
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Preferred first name
Date of birth
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Please note: The Education (Pastoral Care of Tertiary and International Learners) Code of Practice 2021 requires that all students under the age of 10 must live with a parent for the duration of their enrolment at school in New Zealand.
Country of citizenship
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Gender
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Ethnicity
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First language
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Address (In home country)
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Phone number (In home country)
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New Zealand mobile number
Email address
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Social media address
Social media type
How long have you studied English?
Years
Months
What is your level of English?
Sporting Interests
Cultural Interests
Travel Details
Arrival date (if available)
Passport number (if available)
Passport expiry
National ID Number (Chinese students Only)
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Student Visa number (if available)
Student Visa issued
Student Visa expiry
Previous Applications
What is the name of the school you currently attend?
Have you applied to _SCHOOLNAME_ before?
When did you apply?
Have you studied in New Zealand before?
Which school did you study at?
Has a family member or relative ever enrolled at _SCHOOLNAME_ before?
Full name
Year attended
Parents or Legal Guardian Details
Please note: it is a requirement of New Zealand regulations that schools must maintain effective communication with parents and legal guardians. To comply with the requirements, contact information provided in this section MUST be the contact information for the parents or legal guardian.
Parent One or Legal Guardian Details:
First Name
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Middle Names
Family name
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Relationship (eg mother, father, aunt, guardian)
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Occupation
Current AddressCopy Student Address
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Work number
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Mobile number
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Email address
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Passport number
Parent Two or Legal Guardian Details:
First name
Middle names
Family name
Relationship
Occupation
Current addressCopy Student Address
Work number
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Mobile number
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Email address
Passport number
Accommodation Requirements
What accommodation do you require?
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Homestay Information
Letter to Homestay
Please write a short letter (below) to introduce yourself to your new host family. Tell them about your family, what you like, why you're coming to New Zealand any anything else you want them to know.
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Important Homestay Considerations
Please include any important homestay requirements eg vegetarian, that you are allergic to cats, that you attend church, etc. This information is used to help us choose the best homestay for you.
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Designated Caregiver (DCG) Details
(if you are staying with a relative or close family friend)
First name of caregiver
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Middle names of caregiver
Family name of caregiver
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Relationship to student (eg aunt, guardian, close family friend)
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Occupation
New Zealand physical address
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Work number
Mobile number
Email address
Please note: A DCG must be a relative or close family friend of the family. This accommodation must be approved by _SCHOOLNAME_ prior to the student's arrival. Please provide a copy of the passport (and visa if applicable).
Medical and Insurance Information
Do you wish to purchase insurance through the school?
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An appropriate insurance policy is required and must cover travel and health to and from New Zealand and for the entire length of stay in New Zealand. Note: This Policy must be provided in English.
Insurance company
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Insurance policy number
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Insurance policy expiry
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Please add your COVID-19 Vaccination Information (if available)
COVID-19 Vaccine Manufacturer
Date of First COVID-19 Vaccine Shot
Date of Second COVID-19 Vaccine Shot
Has the student been vaccinated for any diseases? (If 'Yes', upload an English copy of your vaccination certificate below)
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Permission is given for _SCHOOLNAME_ to administer Paracetamol.
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Permission is given for _SCHOOLNAME_ to administer Ibuprofen.
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Medical Conditions
ADD/ADHD
Asthma
Autism Spectrum Disorder
Back/Neck Problems
Concussion
Depression/Anxiety
Diabetes
Dizzy Spells
Eating Disorders
Glandular Fever
Hayfever
Heart Condition
Hepatitis A, B or C
HIV or AIDS
Mental Illness/Disorder
Migrianes
Mobility Issues
Seizure Disorders
Significant Allergies
Tuberculosis
Additional medical information
Does the student have any pre-existing medical conditions (for insurance purposes) or history of previous illness that may affect the enrolment, including mental illness? If 'Yes', please provide details. Withholding information may result in your contract being terminated.
Current Medications
If the student suffers from conditions requiring medication, it is advisable to bring their own medication to New Zealand. You will be required to notify the school regarding any medications that you bring with you. The school WILL dispense any over the counter medications as it sees fit to students UNLESS specified below.
Allergies – please list all allergies eg animals, foods, medicine, etc
Doctor name (in home country)
Doctor phone
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Emergency Contact
In your home country, other than your parents
First name
Family name
Relationship to the student
Phone number
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Address
Email address
Course Details
When will you start?
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Term
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Duration
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Terms
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| Finish: |
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INFORMATION REGARDING SUBJECT SELECTION:
Year 9: select 4 option subjects, with at least 1 from each group.
Year 10: select 4 option subjects, with at least 1 from each group.
Year 11: select up to 3 option subjects.
Year 12: select up to 5 option subjects.
Year 13: select up to 6 subjects.
Please note: Course choices will be reviewed after enrolment and may be subject to change and availability.
Year 9: select 4 option subjects, with at least 1 from each group.
Year 10: select 4 option subjects, with at least 1 from each group.
Year 11: select up to 3 option subjects.
Year 12: select up to 5 option subjects.
Year 13: select up to 6 subjects.
Please note: Course choices will be reviewed after enrolment and may be subject to change and availability.
Year/Subjects
Learning and/or behavioural difficulties
Comments
Is there anything further that the school needs to be aware of in enrolling the student as an international student? If 'Yes', please provide details.
File Uploads
Passport
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Your Photo (portrait photo, passport photo or similar)
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Last School Report (translated into English)
Other file
Vaccination Certificate
Insurance Certificate (if available and must be in English)
Copy of COVID-19 Vaccine Certificate (must be in English)
Language Assessment Certificate
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Declarations
All Contract Documents for _SCHOOLNAME_ must be fully read and understood and the Declaration Form signed as confirmation of this. Failure to disclose relevant information or the provision of false information may result in termination of enrolment. Make sure all details on these forms are completed and the correct people have agreed to the enrolment conditions. Please read and understand the contracts before signing.
These are important legal document, please read all clauses carefully. By signing these contracts, you
- declare that the information contained within them is true and complete
- understand that any false or incomplete information submitted in support of your application may invalidate it and may result in the withdrawal of an Offer of Place
- agree that you have received sufficient information to make an informed decision about enrolment at the School
- confirm that where the student is under 10 years of age, the student will live with a parent or legal guardian in New Zealand while enrolled at a school, unless accommodated in a school hostel
The Contract of Enrolment includes provisions that:
- allow the School to discipline the Student, including by expulsion
- control and limit the Student's rights of refund when Enrolment ends early
- require the Parents to make full disclosure of all relevant information
- provide consent for the School to permit certain activities without further consent from the Parents.
You MUST read the below contracts, agree to them by filling out the fields below, and click the ‘Sign Contracts’ button. The contracts will be generated with representative signatures and emailed to you for your records.
- Bethlehem College Enrolment Declaration
- Bethlehem College Hostel Declaration
- Bethlehem College Homestay Declaration
- Designated Caregiver Declaration
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Once you click the button below, the contracts will be generated. This may take a few moments, so please be patient.
You have signed and generated all contracts required for your application. You can view any of the contracts by clicking on the links below.
Application Ready
Thank you, your application is now ready to be submitted. Once your are happy with the information you have provided, click the ‘Submit Application’ button below.
Application Submitted
Thank you! Your application has been successfully submitted. We will be in contact with you shortly.