ST HILDA’S COLLEGIATE SCHOOL
Application For Enrolment
As An International Student
Family Name
Date of Birth (month in words)
First Names
Preferred Name
Country of Birth
Ethnic Group
Passport Country of Issue
Passport Number
How many Terms do you want to study for
What Terms of the Year –
Term 1
Term 2
1
2
Term 3
Term 4
[Please circle which term(s) ]
Year 7 = Age 11
Year 8 = Age 12
Year 9 = Age 13
Year 10 = Age 14
Which Term would you start your study from
4
Year
Level
[What Year (s)]
(Year 7 – 13)
Year 11 = Age 15
1
Parents’ Names
3
[Please circle the number of terms]
Year 12 = Age 16
2
3
(Father)
Year 13 = Age 17
4
(Mother)
Home Address (not New Zealand)
Telephone Number
Fax Number
Cellphone Number
Emergency Contact
Parents’ E-mail Address
(if different from home address)
Language spoken at home
Name of School you are currently attending
(or the name of the last school you attended)
Address of the School
School’s Telephone Number
Highest School Qualification to date
E-mail Address
(Please include transcripts with your latest school report)
Can you provide any information on your English Language ability?
The school reserves the right to place students in courses according to their ability and academic performance .
International students are required to have comprehensive travel, medical and personal effects insurance. This will be arranged by the School
Health Problems
For the purposes of the Privacy Act 1993, I hereby acknowledge:
1.
The information set out in this form has been provided voluntarily.
2.
I/We had a choice as to whether to complete all parts of the form or not.
3.
The information is being collected by the Board of Trustees of St Hilda’s Collegiate School for the purpose of providing a database of
information relating to the future education, guidance, monitoring and reporting of the student’s progress and pastoral care.
4.
The information collected may be used for a variety of statistical and research purposes, while ensuring that no individual can be
identified
I have read the expectations for parents, students and the School as defined in the Prospectus and I agree to follow
all homestay and School rules. I have attached a photocopy of my passport.
Signed: Student:
Parent:
Agent:
Date:
(if applicable)
2 Cobden Street, Dunedin, New Zealand
Telephone +64 3 477 0989 Fax +64 3 477 1222
Website www.shcs.school.nz
E-mail international@shcs.school.nz