Bethlehem College International Enrolment Form

Welcome to the Bethlehem College International Enrolment form.

Please make sure that you have scanned copies of the following documents ready to upload before you begin:

Fields marked with * are required.

Student Details
First name (as on passport)
*
Middle names (as on passport)
Last name (as on passport)
*
Preferred first name
Date of Birth
*
Country of Birth
*
Gender
*
Ethnicity
*
First Language
*
Overseas Address
*




*
Overseas phone number
+--
New Zealand mobile number
Email address
How long have you studied English
Years Months
Sporting Interests
Other:
Cultural Interests
Other:
Agency Details (Only applicable if you are an agent)
Agency
Agent Name
Contact Email
Previous Applications
What was the name of the last school you attended?
Have you applied to Bethlehem College before?
If yes, when?
Have you studied in New Zealand before?
If yes, please state which school
Has your brother or sister enrolled at Bethlehem College before?
Name
Year Attended
Travel Details
Arrival date (if available)
Passport number
*
Passport expiry
*
Student Visa number (if available)
Student Visa issued
Student Visa expiry
Parents/Caregivers Details
Caregiver 1 Details:
First name
Middle names
Last name
Relationship (Mother,Father,Aunt,Guardian)
Occupation
Overseas address




Phone number
+--
Work number
+--
Mobile number
+--
Email address
Caregiver 2 Details:
First name
Middle names
Last name
Relationship (Mother,Father,Aunt,Guardian)
Occupation
Overseas address




Phone number
+--
Work number
+--
Mobile number
+--
Email address
Accommodation Details
Where will you be staying? *
Homestay Information
Letter to Homestay
Please paste in a short letter (below) to introduce yourself to your new host family. Tell them what you like, why you're coming to New Zealand any anything else you want them to know.
Important Homestay Considerations
Please include any important homestay requirements, such as vegetarian, or that you are allergic to cats etc. This information is used to help us choose the best homestay for you.
Designated Caregiver (DCG) Details
First name
Middle names
Last name
Relationship (Aunt,Uncle,Guardian)
Occupation
Local address




Phone number
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 Bethlehem College prior to the student's arrival. Please provide a copy of the passport (and visa if applicable).

Medical Details
Do you wish to purchase insurance through the school? *

Insurance must cover travel and health for entire length of stay in New Zealand.

Insurance company
Insurance policy number
Insurance policy expiry
Medical Information
You must declare all medical details. Withholding information may result in your contract being terminated.
*
The school WILL dispense any over the counter medications as it sees fit to students UNLESS specified above.
Current Medications
*
Allergies
*
Doctor name (in home country)
Doctor phone
+--
Emergency Contact (If other than parent)
First name
Family name
Relationship
Phone number
+--
Address
Email address
Course Details
Study Programme
When will you start?
Year Term
Duration of study?
Terms

Year 9: select 2 option subjects from each of two groups. 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 Difficulties
You must declare any learning difficulties you may have. Failure to notify of any difficulties may result in your enrolment being terminated.
Comments
Is there anything you would like to tell us?
Declarations

Please download print and sign the declaration form, then scan it and attach it below.

File Uploads
Passport
*
Your Photo
*
Last School Report
*
Insurance Certificate
Signed Declaration (see above)
*