Botany Downs Secondary College Signup Form

Fields marked with * are required.

Note: It is important that you include all relevant information about the student in your application. This information is used to ensure that the student is supported properly upon arrival and to match them with suitable homestays, teachers and courses. Where information is included relating to health issues or learning needs, disclosure of this information will not automatically disqualify the Student from Enrolment. However, failure to disclose information or providing misleading information may result in the withdrawal of an Offer of Place or termination of a Contract of Enrolment.

Student Details
First name (as on passport)
*
Middle names (as on passport)
Last name (as on passport)
*
Preferred first name
Date of Birth
*
Country of Birth
*
Gender
*
Ethnicity
*
First Language
*
Overseas Address
*




Country
*
Overseas phone number
+--
New Zealand mobile number
Email address
How long have you studied English
Years Months
Agent Details (Agents must be registered with Botany Downs Secondary College before submitting an application)
Agency
Agent Name
Contact Email for this application

Previous Education
What is the name of your current school?
Have you studied in New Zealand before?
If yes, please state which school
Parents/Caregivers Details
Mother/Caregiver 1 Details:
First name
Middle names
Last name
Relationship (Mother,Father,Aunt,Guardian)
Occupation
Overseas address




Phone number
+--
Work number
+--
Mobile number
+--
Email address
Passport number
Father/Caregiver 2 Details:
First name
Middle names
Last name
Relationship (Mother,Father,Aunt,Guardian)
Occupation
Overseas address




Phone number
+--
Work number
+--
Mobile number
+--
Email address
Passport number

Accommodation Details
Where will you be staying? *
Homestay Information
Tell us about...you
It’s important that we find a host family that is the best match for you. To help, please tell us as much about yourself as you can, the more you can tell us the better. We can make placements without this supporting information but these placements are made at the discretion of the school and will be non-negotiable.
Other Homestay Placement Considerations
Please include important homestay requirements, such as if you are vegetarian, or if you are allergic to animals etc.
Designated Caregiver (DCG) Details

A DCG must be a relative or close family friend of the family. Evidence supporting this relationship may be required.

A Confirmed Offer will not be released until the accommodation is approved by Botany Downs Secondary College.

First name
Middle names
Last name
Nature of Relationship (Relative, family friend)
New Zealand address




Contact number
Email address
Medical Details
Do you wish to purchase insurance through the school? *

Insurance must cover travel and health for entire length of stay in New Zealand.

Insurance company
Insurance policy number
Insurance policy expiry
Medical Conditions
Do you have any of the following
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
Pre-existing medical conditions
You must declare any pre-existing conditions. The Studentsafe Inbound Learners policy does not automatically cover pre-existing medical conditions. A pre-existing condition is a medical or physical condition that you had before you enrolled in the plan and can extend to conditions you were aware of but did not seek treatment for. Cover can be arranged in certain circumstances by completing a medical assessment form. An additional premium will be charged if cover is approved.Withholding information may result in your contract being terminated.

The school WILL dispense any over the counter medications as it sees fit to students UNLESS specified above.
Current Medications
Allergies
Doctor name (in home country)
Doctor phone
+--
Emergency Contact (Other than parent)
First name
Family name
Relationship
Phone number
+--
Address
Email address
Study Intentions
When do you intend to start?
Year Term Duration Terms

In Year 9, all subjects are compulsory. In Year 10, students choose 3 option subjects (English, Maths, Science, PE/Health, Social Studies are compulsory) In Year 11, choose 3 options (English, Maths, Science compulsory) In Year 12, choose 5 subjects. (English compulsory) In Year 13, choose 5 subjects Options may be changed later.

Year/Subjects
Learning Difficulties
You must declare any learning difficulties you may have. Failure to notify of any difficulties may result in your enrolment being terminated.

Comments
Is there anything you would like to tell us to help your application?
Declarations

Please download, print and sign the declaration form, then scan it and attach it below.

File Uploads
Passport
Your Photo
Last School Report
Insurance Certificate
Signed Declaration (see above)
*