LI Online – Application form Please fill out this form to apply to join one of our online courses. You will not be asked to pay now. (We will send you an invoice.) You must be at least 17 years old to apply. If you have any questions, you can contact Languages International at info@languages.ac.nz. LocationAre you currently in New Zealand?YesNoStudent's detailsTitle*MrMsFamily name*Given name(s)*Date of birth* Date Format: MM slash DD slash YYYY AgePlease enter a number from 1 to 99.Email* Telephone numberCountry of residenceAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweNative languageCourse(s) wantedEnglish for University – Access English for University – Access To enrol in this course you need to take a pre-test. You can take the test after you finish filling out this form. The test is here: www.languages.ac.nz/courses/test-your-english/ (The test will open in a new window).Start date*(You have to start on course start date.) Date Format: DD slash MM slash YYYY Conversation Conversation To enrol in this course you need to take a pre-test. You can take the test after you finish filling out this form. The test is here: www.languages.ac.nz/courses/test-your-english/ (The test will open in a new window).Start date(You can start on any Monday.) Date Format: DD slash MM slash YYYY Number of weeks of tuition*AgentI have an agent.I do not have an agent.What is the name of the agency?Declaration* 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.Digital signature (Your full name)*Date* Date Format: DD slash MM slash YYYY Please click the 'Send application' button below to send your application. (You will not be asked to pay now.)