Online Application and Contract for Enrolment
of International Student for Glendowie Primary School

Family Name / Surname
Given Name / Christian Name
Preferred Name
Date of Birth
Nationality
Address Overseas 
Class / Year Level Preferred (if known)
Mother’s Details
Mother’s Name
Mother’s Address
Phone Number: (Day)
(Night)
Employment
Father’s Details
Father’s Name
Father’s Address
Phone Number: (Day)
(Night)
Employment
Please check one
Living with parent / parents / legal guardian
Living with designated caregiver - applicable only for Yr.7/8
Home stay arranged - applicable only for Yr.7 / 8
Accommodation in New Zealand
Student’s address in New Zealand
Phone Number
Introduced by Recruitment Agency (if applicable) Yes No
Name of Recruitment Agency in New Zealand
Phone Number of Recruitment Agency
Name of Someone to Contact in an Emergency
1. In Home Country 2.  In New Zealand
Name Name
Address Address
Phone: (Day) Phone: (Day)
(Night) (Night)
Student Health: It is a condition of enrolment that the student has adequate Travel/Medical Insurance.  
1.  Do you have any medical problems? No
Yes (Give details below)
(Students may have to undergo further medical screening at the student’s expense).
2.  Have you already arranged medical or travel insurance? Yes
No
3.  Have you any special needs (other than English) which may hinder your learning? No
Yes (Give details below) 
 
 
Level of English Competency - Please tick the most appropriate
No prior learning of English
Beginning level of English – under 6 months learning English
Level of English learnt is between 6 months and 2 years
Advanced level of oral and written English
Offers of Course placement will be based on an assessment by the school and are matched to the educational opportunities offered by the school.  Should your application be successful, you will receive a letter of offer (“offer of a place”).  However, you will need to pay the year’s fees in advance before tuition is started.  If you accept the offer of a place then this application for enrolment and the tuition agreement provided by the school shall be the terms and conditions of agreement by which tuition shall be provided to the student.  The terms must be signed by a parent or guardian if the student is under the age of 20 years.  The parent or guardian shall be bound by these terms and conditions.  
Date intended to commence study at Glendowie School
Date you intend to complete study at Glendowie School
Period of tuition being applied for
In any enrolment involving a false declaration the Board of Trustees may decline the International Student enrolment.  The Board may rule that the International Student is no long eligible to be within our school.
I certify the above information is true and correct:
Print Name
Before taking up enrolment – the following needs to be sited or completed. Copies of documents and the  Acceptance of Terms details below need to be posted or faxed  to:


Glendowie Primary School
217 Riddell Road
Glendowie
Auckland 1005
New Zealand

Phone/fax: (+649) 575 7374

 
Include the following:
- A certified copy in English of your most recent school report.
- A copy of the passport showing the student permit.
- All areas of the application form completed.
- A copy of Parent's Visa for students Years 1-6
- A copy of travel and medical insurance
Acceptance of Terms:
Before your child's application is accepted you will need to print the following statements and complete the details below and send.  The signature needs to be  signed by a parent or guardian of a student under the age of 20 years.

 
1. I agree to abide by the rules and policies of the school at all times.
2.   I accept the right of the school to effect a change of course or year group if this is considered to be in my best interests.
3. I have read, understood and signed the attached tuition agreement which shall apply if my application is successful.
Signed:
Date:
Full Name
Relationship to Student 
Address 
Country
Phone 
Fax
Email