Personal Information

Personal Info

Course Selection

Additional Support

Documents

Submit

Given Name *

Family Name *

Gender *

Male Female Other

Date of Birth *

Address in New Zealand

Phone in New Zealand

Email *

Have you completed any English tests or English courses at any other education provider(s) in NZ before? *

Yes (Please provide details below) No

Have you used an education consultant or agent when applying for this enrolment? *

Yes, an Education Consultant/Agent Yes, a Referrer No

I am an international student

Address in Home Country *

Phone in Home Country *

Country or Jurisdiction of Citizenship *

Passport Number *

Passport Expiry Date *

If you are already in New Zealand, what type of visa you are currently holding:

Student Visa Work Visa Visitor Visa Other

Please provide an NZ contact person

Full Name

Relationship to Applicant

Phone

Address

Zealive Institute of New Zealand