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New Zealand Education Global Services Ltd Client's Application to Enroll and Agent Commission Bank details

It is better for you to fill in the form so we can better service your request. If you prefer to e-mail us with a simple question please click here.

Please note that fields marked with must be filled in before submitting.

Client Information
Which school do you wish to apply to?
Family Name:
First Name:
English Name:
Gender:		Male Female
Date of Birth (dd/mm/yy):
Age:
Nationality:
Ethnic Group:
Country of Passport Issue:
N.Z. Visa Number:(if required)
Expires Date(mm/yy):
Occupation:

Address in Home Country
Address:
Tel:
Fax:
E-mail
Address in New Zealand if known
Address:
Tel:
Fax:
E-mail
Emergency Contact
Name:
Address:
Tel:
Fax:
Relationship to you:

Medical Information
Do you have any allergies or medical requirements?		Yes No
If yes, please give details:
Insurance Details
New Zealand Education Global Services Ltd. recommends that every international student have Medical/Travel Insurance.The New Zealand Government requires you to have Medical Insurance while you are studying in New Zealand. New Zealand Education Global Services can arrange this for you.
Do you require information about this Insurance:		Yes No
Arrival Details
At what airport do you need to be picked up from? (Please note, there are airport pickup fees for most schools).
Date of arrival:
Time of arrival:
Airline name:
Flight number:

Accommodation
Do you want accommodation arranged for you?		Yes No
What form of accommodation do you require?
Please enter the date accommodation is needed:(Please note, there may be an accommodation registration fee)		to

Home-stay Information
To help us find a home-stay family that you will feel comfortable with, please tell us about yourself.
Do you have any special food requirements?(Vegetarian, religious reasons, etc.)		Yes No
If Yes, Please give details:
Do you smoke? (Smoking is uncommon in New Zealand homes and banned in most public places)		Yes No
Do you want a home-stay with children?		Yes No
Do you want a home-stay with indoor pets? (In many New Zealand Homes cats and dogs live indoors)		Yes No
Please tell us about you, your hobbies and interests.

Enrollment details
How many years have you studied English:
Have you taken any International English Exams?		Yes No
I wish to study in the following program:
I wish to start this program from:		to
Marketing Information
How did you find out about New Zealand Education Global Services LTD?
If you were searching on the Internet, what key words and search engine did you use to locate our services?
How did you learn about the school you want to attend?
Student Declaration (Must be filled out by persons over the age of 18) I declare the information in this application to be true and correct. I understand and agree to the terms and conditions of enrolment at my chosen institution. I understand that I am bound by the policies outlined by the school I am enrolling to. I declare that I have not withheld any information, which could have any material bearing on my enrolment.
Please enter your name here:
I AGREE with the terms as stated above (check the box)
Remember, this does not require payment and can be withdrawn if your plans change.
DECLARATION: I understand that the conditions of cancellation and any refund policies from New Zealand Education Global Services Ltd. are dictated by the school for which you enroll. We strictly adhere to their policies. I am responsible to request those policies from the school I enroll into. New Zealand Education Global Services Ltd. is not responsible for any false information given by its clients. We also strongly advise our clients to acquire travel insurance in case of any unexpected circumstance that may arise during their stay in New Zealand. I will not hold NZEGS Ltd. responsible for any such circumstances. I am signing the enrolment form by pushing the "submit" button. Read NZEGS LTD's Refund Policy Here.
Please answer: 2 + 2 =

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