Enrolment Form


    IMPORTANT NOTE FOR STUDENTS UNDER 18 YEARS:
     Parents must fill in, sign and fax or email their child's enrolment form to RELA
    before their child arrives at the school. click here for under 18 enrolment form

    Personal Details

    Family Name:

    Date of Birth:

    /

    /

    Given Name:

     

    Day / Month / Year

    Preferred Name:

    Gender:

    Have you studied at RELA before?:

    Passport Number:

    Nationality:

    Type of Visa:

    Visa Exp:

    Are you a NZ Resident?

    Are you a NZ Citizen?

    Emergency name

    Emergency Number

    Emergency address

    Overseas Home Details

    Home Address:

    Home Country:

    Home City

    Home Phone:

     

     

    Home Fax:

    Home Postal Code:

    Home Email:

    New Zealand Details

    NZ Address:

    NZ City

    NZ Fax:

    NZ Phone:

    NZ Mobile:

    NZ Email:

    Course Details

    Start Date:

    Day / Month / Year

    /

    /

    Finish Date:

    /

    /

    Which course do you want to join?

    How many hours per week do you want to study?

    What is your current level of English?

    Why do you want to learn English?

    How did you hear about RELA?

    Agent's Name (if any):

    Accommodation

     

     

    Day / Month / Year

    First Night:

    /

    /

    Last Night:

    /

    /


    Transport

    Arrival
    I want RELA to arrange transport from

    Departure
    I want RELA to arrange transport to

    Insurance

    You must have Travel and Medical Insurance while in New Zealand. This is to meet requirements of the New Zealand government. RELA can buy the insurance through Uni-care for you.

    I want RELA to arrange Insurance for me:
    Pre-existing conditions will probably not be covered

    Do you have a health problem we should know about?

    If yes, please state:

    Please write your Insurance finish date

    Code of Practice

    Rotorua English Language Academy (RELA) has agreed to observe and be bound by the Education (Pastoral Care of Tertiary and International Students) Code of Practice 2021 administered by the Ministry of Education. Copies of the Code are available on request from this institution or from the NZQA website at https://www.nzqa.govt.nz/providers-partners/education-code-of-practice/

    Immigration :
    Full details of visa and permit requirements, advice on rights to employment in New Zealand while studying, and reporting requirements are available through Immigration New Zealand, and can be viewed on their website at www.immigration.govt.nz.

    Eligibility for health services :
    Most international students are not entitled to publicly funded health services while in New Zealand. If you receive medical treatment during your visit, you may be liable for the full costs of that treatment. Full details on entitlements to publicly-funded health services are available through the Ministry of Health, and can be viewed on their website at www.moh.govt.nz

    Accident Insurance :
    The Accident Compensation Corporation provides accident insurance for all New Zealand citizens, residents and temporary visitors to New Zealand, but you may still be liable for all other medical and related costs. Further information can be viewed on the ACC website at www.acc.co.nz

    Medical and Travel Insurance :
    International students must have appropriate and current medical and travel insurance while studying in New Zealand. We strongly recommend that this insurance covers your travel to and from New Zealand as well as for the duration of your stay.

    Privacy

    Rotorua English Language Academy (RELA) collects and stores information from this form to manage the business (including internal reporting and administrative processes) , to comply with the requirements of the Education Act 1989 and other legislation relating to maintenance of official records and accountability for public funding, and to supply information to government agencies and other organisations as set out below. RELA may add your personal details (name, date of birth and residency) to the National Student Index, which is managed by the Ministry of Education.

    Supply of information to government agencies and other organisations

    RELA supplies data collected on your enrolment to government agencies, including the Ministry of Education, the New Zealand Qualifications Authority, the Tertiary Education Commission, Immigration New Zealand (a branch of the Ministry of Business, Innovation and Employment): for those who are not New Zealand citizens or permanent residents. These agencies use the data supplied by tertiary education organisations to administer the tertiary education system, including allocating funding', develop policy advice for government and conduct statistical analysis and research. The Ministry of Education may supply data collected on this form to Statistics New Zealand for the purposes of integrating data with data collected by other government agencies, subject to the provisions of the Statistics Act 1975.  Integrated data is used for the production of official statistics, to inform policy advice to government and for research purposes. When required by law, RELA releases information to government agencies such as the New Zealand Police, Department of Justice, Ministry of Social Development, and the Accident Compensation Corporation (ACC). Information collected on this form may be supplied to other educational organisations for the purpose of verifying academic records.

    I give permission for any photos taken of me to be used by RELA for marketing purposes on their website, in their brochure, on their Facebook pages and on Instagram.

    Student Fee Trust Account Application Form (Agent Authority)

    1. All students enrolling in a course with total fees of $500 or more are required to establish a Student Fee Trust Account by completing a Student Fee Trust Account Application Form (Application Form).

    2. The Application Form must be signed by a student (or a student's Guardian if the student is under 18 years old) and returned to RELA with this Enrolment Form.

    3. If RELA does not receive a signed Application Form with this Enrolment Form and a student is under 18 years old then by signing this Enrolment Form the student's guardian agrees to appoint RELA as their agent to sign the Application Form on their behalf

    4. This Agent Authority is limited as outlined above and does not permit RELA to sign any withdrawal or refund form on behalf of a student or student's guardian.

    Privacy Waiver for INZ

    By signing this enrolment form, I authorise the School Manager or Director at Rotorua English Language Academy, or the Executive Director at English New Zealand, to discuss my visa application for this provider with Immigration New Zealand; to obtain information regarding the processing of the visa application and the decision on the application.

    Declaration

    I declare to the best of my knowledge all the information supplied on, and with this enrolment form is true and complete, I agree to abide by the conditions described above, and I consent to the disclosure of personal information as described above. I agree to the
    Conditions of Enrolment of Rotorua English Language Academy.

    By signing this enrolment form, I acknowledge that I have read and agree to be bound by:

    The Conditions of Enrolment
    The Refund Policy
    The School Rules
    The Complaints Procedure

    Date:

    * Once your enrolment form has been submitted we will contact you with an invoice and information about your course of study.

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