Course Extension/ Transfer Form - Languages International

Family name(s)*

Given name(s)*

Date of birth*

Extension start date*

Number of course weeks*

Course

General English (GE)

Study type

full-time
part-time

English for Business (EB)

Study type

full-time
part-time

English for University (EU)

Executive course / One-to-one

IELTS

Study type

full-time
part-time

IELTS Academic Writing Evening Class

Cambridge Exam Preparation

Visa

What visa do you currently hold?*

Visitor visa
Student visa
Working Holiday visa
Work visa
Residence visa
other

What is the end date of your current visa?*

Insurance is compulsory

By law you cannot start classes without proof that you have purchased Medical and Travel Insurance.
International Students must have appropriate and current medical and travel insurance while studying in New Zealand. We arrange a low cost insurance with generous benefits designed especially for students coming to New Zealand. It includes cover for your international travel and loss of fees if your course is interrupted by an insurable event.

Please check one*

My current insurance is valid until the end of my stay in NZ
I will arrange my own insurance until the end of my stay in NZ
Please arrange insurance for me

Do you have any pre-existing medical conditions § ?

Yes
No

§ A pre-existing medical condition is a condition that started before you applied for your insurance. If you answered 'Yes' to this question, you will have to complete a form on the Uni-Care website.

Declarations

*

I have read and accept the Conditions of Enrolment.

*

I have read and accept the privacy statement below.

We process the data you give us on behalf of our company, with the purposes of providing the requested service(s) and of billing for the service(s). The data you give us will be kept for the length of time necessary to comply with legal obligations. The data will only be shared with third parties to enable us to manage your booking and deliver our services, in cases of emergency or where we have a legal obligation. Please visit https://www.languages.ac.nz/privacy/ to see exactly how your data is shared. You have the right to access your personal data, as processed by Languages International, and to correct inaccurate data or ask for its deletion when the data is no longer needed.

*

I give permission for Languages International and Immigration New Zealand to share information about my visa with each other.

Digital signature (Your full name)*

Date*