Palmerston North Boys' High School

International Student Application Form

Application Progress
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Information Required
Important: You must include all relevant information about the student in this application. This will ensure that the student is correctly supported upon arrival and matched with a suitable homestay, teachers and subject courses. Where information relates to health issues or learning needs, honest disclosure of information will NOT automatically disqualify the student from enrolment. However, failure to disclose or providing misleading information may result in the withdrawal of an Offer of Place or termination of a Contract of Enrolment.
Before you begin this application, please have scanned copies of the following documents ready to upload:
  • Current passport
  • Portrait photo
  • Last school report (English translation)
  • Vaccination certificate, if available (English translation)
  • Insurance certificate, if available (English translation)
Note: Fields marked with
are compulsory
THIS APPLICATION MUST BE COMPLETED IN ENGLISH
Your information is saved every time you press the ‘Next Section’ button. Need a break? You can come back at any time at the link below.
Agent Details
Complete this section if you are applying through an Education Agent
Agency name
Agent name
Agent email address
Tick for communication to Agent only (the student will NOT receive any application information or emails)
Student Details
First name (Name must be as it appears on your passport)
Middle names (must be as it appears on your passport)
Family name (must be as it appears on your passport)
Preferred first name
Date of birth
Note: The Education (Pastoral Care of Tertiary and International Learners) Code of Practice 2021 requires that all students under the age of 10 must live with a parent for the duration of their enrolment at school in New Zealand.
Country of citizenship
Gender
Ethnicity
First language
Address (In home country)
Phone number (In home country)
+--
New Zealand mobile number
Email address
How long have you studied English?
Years Months
What is your level of English?
Sporting Interests - tick the sports which you participate in:
Cultural Interests - tick the activities which you participate in:
Travel Details
Anticipated arrival date in NZ (if known)
Passport number
Passport expiry
National ID Number (Chinese students Only)
Student Visa number (if available)
Student Visa issued
Student Visa expiry
Previous Applications
What is the name of the school you currently attend?
Have you applied to _SCHOOLNAME_ before?
When did you apply?
Have you studied in New Zealand before?
Which school did you study at?
Has a family member or relative ever enrolled at _SCHOOLNAME_ before?
Full name
Year attended
Parent/s or Legal Guardian Details
Note: New Zealand regulations state that schools must maintain effective communication with parents and legal guardians. To comply with these requirements, information provided in this section MUST be the contact information for the parent/s or legal guardian.
Parent One or Legal Guardian Details:
First Name
Middle Names
Family name
Relationship (eg mother, father, aunt, guardian)
Occupation
Current AddressCopy Student Address
Work number
+--
Mobile number
+--
Email address
Passport number
Parent Two or Legal Guardian Details:
First name
Middle names
Family name
Relationship
Occupation
Current addressCopy Student Address
Work number
+--
Mobile number
+--
Email address
Passport number
Accommodation Requirements
Which type of accommodation do you require?
Homestay Information
Letter to Homestay
Please write a self-introduction to your new host family. Tell them about your family and pets, your interests, your reason for coming to New Zealand and anything else you would like them to know about you.
Specific Homestay Requirements
Please list any specific homestay requirements or preferences you may have (e.g. vegetarian, allergic to cats, regularly attend church, etc). This information is used to help us match you with the best possible homestay family.
Designated Caregiver (DCG) Details
Note: A DCG must be a relative or close friend of the student's family. Any DCG accommodation MUST be approved by _SCHOOLNAME_ prior to the student's arrival. A copy of the DCG's passport will be required at a later date.
First name of caregiver
Middle names of caregiver
Family name of caregiver
Relationship to student (eg aunt, guardian, close family friend)
Occupation
New Zealand physical address
Work number
Mobile number
Email address
Medical and Insurance Information
Do you wish to purchase insurance through the school?

Insurance is compulsory and must cover both travel and health to and from New Zealand, and for the entire length of your stay from arrival to departure. This Policy MUST be provided in English.

Insurance company
Insurance policy number
Insurance policy expiry

Please add your COVID-19 Vaccination Information (if available)

COVID-19 Vaccine Manufacturer
Date of First COVID-19 Vaccine Shot
Date of Second COVID-19 Vaccine Shot
Has the student been vaccinated for any diseases? (If 'Yes', upload an English copy of your vaccination certificate in the File Uploads section)
_SCHOOLNAME_ is permitted to give the student Paracetamol medicine, if necessary.
_SCHOOLNAME_ is permitted to give the student Ibuprofen medicine, if necessary.
_SCHOOLNAME_ is permitted to give the student antihistamine, if necessary.
Medical Conditions
ADD/ADHD Asthma Back/Neck problems Glandular Fever Migraines Diabetes Hepatitis A, B or C Depression/Anxiety Heart Condition Mobility Issues Tuberculosis Food Allergies Eating Difficulties Epilepsy Bee/Wasp Sting Allergy Metal Implants Any Mental Illness HIV or AIDS Autism Asperger's
Additional medical information
Does the student have any pre-existing medical conditions (for insurance purposes) or history of previous illness, including mental illness? If 'Yes', please provide details. Withholding information may result in the enrolment contract being terminated.
Current Medications
Does the student take regular medication for any medical conditions? If 'Yes', it is advisable to bring this medicine to New Zealand. Please list below any required medication and the medical condition it is for:
Allergies – please list all allergies that the student is affected by (e.g. food, medicine, animals, etc):
Doctor's name (in home country)
Doctor's phone
+--
Emergency Contact
Please provide details of an emergency contact person in your home country (not your parents)
First name
Family name
Relationship to the student
Phone number
+--
Address
Email address
Course Details
Select a study programme:
When will you start?
Term
Duration
Terms
Start:
Finish:
INFORMATION REGARDING SUBJECT SELECTION:

Subject preferences in this application are an indication only and actual subjects will depend upon availability and prior learning. The school reserves the right to determine subject placement and year level throughout enrolment in consultation with students and families.

YEAR 9 - Compulsory subjects are English, Maths. Please select 3 optional subjects from the list below


Please select subjects of interest.
Year/Subjects
Learning and/or behavioural difficulties
Activity Programme
Additional Comments
Is there anything further that the school should know regarding the enrolment of this international student? If 'Yes', please provide details:
File Uploads
Passport
Remove and re-upload
Upload
Portrait Photo
Remove and re-upload
Upload
Last School Report (English translation)
Remove and re-upload
Upload
Vaccination Certificate (English transalation)
Remove and re-upload
Upload
Insurance Certificate (English translation)
Remove and re-upload
Upload
Language Assessment Certificate
Remove and re-upload
Upload
Other file (e.g. letter of reference, photo collage, etc)
Remove and re-upload
Upload
Declarations

All Contract Documents for _SCHOOLNAME_ must be fully read and understood and the Declaration Form signed as confirmation of this. Failure to disclose relevant information or the provision of false information may result in termination of enrolment. Make sure all details on these forms are completed and the correct people have agreed to the enrolment conditions. Please read and understand the contracts before signing.

These are important legal documents, please read all clauses carefully. By signing these contracts you:

  • declare that the information contained within them is true and complete
  • understand that any false or incomplete information submitted in support of your application may invalidate it and may result in the withdrawal of an Offer of Place
  • agree that you have received sufficient information to make an informed decision about enrolment at the School
  • confirm that where the student is under 10 years of age, the student will live with a parent or legal guardian in New Zealand while enrolled at a school, unless accommodated in a school hostel

The Contract of Enrolment includes provisions that:

  • allow the School to discipline the Student, including by expulsion, or to remove them from the School on health and welfare grounds;
  • control and limit the Student's rights of refund when Enrolment ends early;
  • require the Parents to make full disclosure of all relevant information; and
  • provide consent for the School to permit certain activities without further agreement from the Parents.

You MUST read all the Contracts listed below, agree to them by typing your name in the compulsory signature boxes, and click the ‘Sign Contracts’ button (Note: Education Agents MUST NOT sign these Contracts on your behalf). The contracts will be generated with representative signatures and emailed to you for your records.

Once you click the button below, the contracts will be generated. This may take a few moments, so please be patient.
You have signed and generated all contracts required for your application. You can view any of the contracts by clicking on the links below.
    Application Ready
    Thank you! Your application is now complete. When you are ready, please click the ‘Submit Application’ button below as the final step in your online enrolment. Your application will be automatically submitted.
    Submit Application
    Application Submitted
    Thank you! Your application has been successfully submitted. We will be in contact with you shortly.
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