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International Student Enrolment Form

"*" indicates required fields

Part One: Personal Information

Student Name*
DD slash MM slash YYYY
Gender*
Student's Address*
Do you need to attend church or another place of worship on a regular basis?

Passport / Visa Details

DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
What International Student category will you be?*
How long will you be studying at Cullinane College?*

Parent’s Details

Mother's Name*
Mother's Address*
Father's Name*
Father's Address*

Emergency Contact Details

Emergency Contact Name*
Emergency Contact Country*

Agent Details

Agent's Name*
Company Address*
Contact should be through:*

Part Two: Living Situation in Your Home Country

Do you have any brothers or sisters?*
How many brothers or sisters do you have?*
Sibling One Name*
Sibling One Gender*
Does this sibling live at home?*
Sibling Two Name*
Sibling Two Gender*
Does this sibling live at home?*
Sibling Three Name*
Sibling Three Gender*
Does this sibling live at home?*
Sibling Four Name*
Sibling Four Gender*
Does this sibling live at home?*
Sibling Five Name*
Sibling Five Gender*
Does this sibling live at home?*
Not counting yourself or any brothers and sisters, how many other people live in your home?*

Who else lives in your home? (Mother, Father, Uncles, Aunts, Grandparents, etc)

Lives at Home One*
Lives at Home Two*
Lives at Home Three*
Lives at Home Four*
Lives at Home Five*

Part Three: Hobbies, Interests and Sports

What sports do you play? Please list your level of experience next to each sport, e.g. social player, school team, regional representative etc.

Singing and Musical Instruments

Do you sing?*
Are you in a band or a choir?*
Do you play any musical instruments?*

Part Four: Health Information (Parents to Complete)

Does your child have any pre-existing medical conditions or concerns?*
Does your child have any allergies, e.g. food allergies like peanuts or wheat, or medical allergies like penicillin or bee stings?*
Does your child carry any medication for this allergy?*
Are there any family medical conditions that we should know about to ensure the safety of your child, e.g. food allergies, bee sting allergies?*
Does your child have any other special health or medical needs?*
Does your child have any psychological / emotional needs?*
New Zealand children are vaccinated against the following diseases. Please select the ones your child has been vaccinated against:*
Has your child had, or suffer from, any of the following illnesses?*
Do you give permission to administer paracetamol if needed?*

Part Five: Study Information (Parents to Complete)

Does your child have any specific learning needs or difficulties that could affect their progress?*
Does your child have any behaviour issues?*
What is your estimate of your child’s level of English?*
Would you like a personal English Tutor at a cost of $50 NZD per hour?*

ESOL (English for Speakers of Other Languages)

ESOL is a language support program to help students integrate successfully into the classroom and their new environment.

ESOL will be a mandatory subject for students whose English proficiency needs improvement but is not a requirement for admission to the college.

ESOL Declaration*

Mandatory Subjects

NCEA Requirements

The National Certificate of Educational Achievement (NCEA) is the main qualification for secondary school students in New Zealand. In most cases it is not a requirement of the home school / country that students obtain NCEA while in New Zealand but in some instances it does apply. Please note that if NCEA assessments are required, then a separate fee must paid to the Ministry of Education. The current fee for International Student Entry to NCEA Standards NZ$383.30 per year. https://www2.nzqa.govt.nz/ncea/about-ncea/

NCEA Declaration*

Learning Support - Sharing of Personal Information Consent

Why we share information

Our school is part of a group of education providers that shares information to:

  • identify children and young people who might need additional learning support.
  • ensure that the adults who work with children (such as teachers or teacher aides) have the skills and resources they need to support them.
  • decide what additional learning support would help children and young people, whether individually or in groups.

The Ministry of Education may use information on the register for the purpose of administration and analysis, for example to find out about the overall numbers of children requiring specific types of support. This will allow the Ministry to plan ahead for numbers of staff and specialists, and other services and types of support.

What information we will share?

The members of our group of education providers RTLB and the Ministry of Education share information for a collective learning support register that contains:

Name, gender and ethnicity to identify support that reflects the child’s identity, language and culture, date of birth and year level, to identify support that is appropriate to their age the type of support needed any health issue, disability or learning difficulty that means a child needs particular types of support services and support they are already receiving.

If you agree, we will put information about your child’s additional support needs on the group’s learning support register.

Who will see the information?

Only a small group of people will have access to the register for the purposes explained in the first paragraph. It will include a school staff member with responsibility for learning support (e.g. special education needs coordinator), appropriate school Dean, senior management in charge of pastoral, a resource teacher learning and behaviour and the learning support facilitator (a Ministry of Education staff member). These people will meet regularly to discuss the register and how best to respond to the needs of children and young people on the register. In some situations, other organisations may be able to help to determine the appropriate support for a child or young person. We will seek your agreement before other organisations are involved.

How we will keep the information safe?

Any information will be transmitted and stored securely in a protected document, which only authorised people will be able to access.

Information about children and young people no longer enrolled with an education provider in the community or no longer needing learning support will be removed from the group register quarterly.

How you can see and correct the information?

You can request access to the information through the school/kura office/early learning service manager and may correct any inaccuracies.

What will happen if you don’t agree to your child’s information being shared?

If you do not agree to your child’s information being included on the register, we will still provide support for your child’s needs within our school. But if your child’s information is not on the register, they may not be able to gain early access to resources provided across the group.

You can decide to withdraw your consent at any time.

Learning Support Declaration*

International Student Trips

We have two optional International Student Trips planned for 2025. You can see more on each trip on the International Student Trips page. Trips are not mandatory and you can choose to go on none, one or both. All trips have a cost associated that are paid for near the time of departure.

Trip Choices

Part Six: Study Information

Part Seven: Other Information

Have you travelled to other countries before?*
Have you lived away from your family before?*
Do you plan to return home in the term holidays?*

Part Eight: Information to Help the School Place You in Classes

Parent / Agent:
The student needs to complete an essay. Please encourage but do not write for them.

Student:
So that we can assess your level of English, please complete an essay in your own hand writing. This should be your own work with no assistance from anyone. Complete your essay on the topic below and upload it when done.

Essay Topic
What do you expect and what do you hope to achieve and during your time in New Zealand? What are your future career or study intentions for the future?

Max. file size: 256 MB.

Part Nine: Letter to Your Homestay Family

Write a letter introducing yourself to your homestay family and upload it below.

Max. file size: 256 MB.

Part Ten: Other Uploads

Please upload the other required documents to support you application.

Please upload a recent passport size photo.
Max. file size: 256 MB.
Please upload a copy of your current, valid passport.
Max. file size: 256 MB.
Please upload a copy of your student visa or copy of an email verifying that it is in process.
Max. file size: 256 MB.
Please upload a copy of your two latest school reports.
Max. file size: 256 MB.
Please upload your Medical Certificate signed by a Doctor.
Max. file size: 256 MB.
Have you organised Medical and Travel Insurance?*
Medical and Travel Insurance are compulsory for all International Students while in New Zealand. If you have not organised Medical and Travel Insurance, Cullinane College can arrange it for you and you will be invoiced.
Please upload your Medical and Travel Insurance Documents.
Max. file size: 256 MB.

Part Eleven: Media Release Declaration (Parents to Complete)

Our students love to see photos of themselves and their friends. We sometimes use photos to record our assessments, as part of sports events, house events, and around the classroom. We also use many photographs in our fortnightly newsletter that update you on your child's progress inside and outside the classroom.

Please indicate if you give permission for your child’s photo to be taken for these purposes.*

Cullinane College is on Facebook/Instagram. Our Facebook/Instagram page will be used to share news, reminders, and information about your child’s school events. We are also putting together new Prospectus, Enrolment packs, International booklets, and a new College website.

Please let us know if we have permission to include your child’s photo for these purposes.*

Part Twelve: Contract Agreement and Declaration

This agreement may be signed by only one parent if the student is legally the responsibility of that parent.

General (Parents)

The parties agree that all relevant provisions of the Education Act 1989 shall apply to the student in New Zealand. Any decision under these provisions to expel or exclude the Student will follow the Ministry of Education’s guidance for schools on stand-downs, suspensions, exclusion and expulsion and shall terminate this Contract.

  1. Condition of acceptance: If this application contains incorrect information, the student will not be accepted into Cullinane College and if already accepted may have their application terminated.
  2. We (parents or legal guardian/s) accept responsibility for the full payment of all tuition and homestay fees in advance.
  3. We understand that in addition to fees paid to the school, we will be responsible for payment of any personal debts accrued by our son/daughter. We accept that the school can use the homestay money to settle any debt at any time.
  4. That acceptance to a particular course is subject to the student’s level of English language being at the level appropriate to the course. If further tests after the student has reached New Zealand demonstrate otherwise, the school will approach the parents for any extra costs.
  5. All students under the age of 14 must have a native speaking guardian.
  6. In case of dispute, we accept that the New Zealand law applies at all times.
  7. If the student has a pre-existing medical condition that is not disclosed at the time of enrolment and this medical condition makes education at Cullinane College difficult this non-disclosure is grounds for termination of this contract.
  8. Cullinane College responsibility ceases at the time that the student leaves the school at the end of the period of enrolment.

Behaviour (Students)

  1. Obey the laws of New Zealand. No student may take any illegal drugs or purchase alcohol.
  2. Obey the school rules. Attend all classes regularly and always work to the best of your ability.
  3. No student may drive a car or motorbike, without the permission of the School and their parents.

Safety

  1. If travelling without your host family outside of Whanganui, you must obtain written permission from:
    • Your own parents
    • Cullinane College
    If you are under 18 it is unlikely that the school will permit you to travel independently.
  2. You must obtain written permission as above for higher risk/adventure activities e.g. Bungy jumping, white water rafting, skiing, small airplane sightseeing rides, or any activity that may be considered dangerous or high risk.
  3. You must have permission from your parents and the school to travel in a car or motorbike with a driver younger than 25 years. The driver must have a full licence.

Homestay Rules

This Contract is subject to the Student being placed in accommodation that is approved by Cullinane College. Cullinane College will make every reasonable attempt to provide approved accommodation for the Student and the Student agrees to comply with all expectations and conditions for living in Cullinane College approved accommodation.

  1. It is expected that you will become a member of the host family. As such, you will be treated as a member of that family and will be expected to participate in family activities. You are required to do the following:
    • If you are going out, ask permission first and explain when you will be home.
    • If you are likely to be late home, telephone or text your family.
    • Be home by the time set by the homestay family. No later than 10:00 pm.
    • Keep your bedroom tidy.
    • No consumption of alcohol or recreational drugs are permitted.
    • Help around the house. Accept responsibility for reasonable jobs, e.g. help with the dishes.
    • You will pay for your toll calls and internet charges. Your host family may choose to control your access to the internet.
  2. You may not stay overnight at any house unless has been confirmed by the International Director.

The Education Act 1989

  1. The Education Act 1989 controls the exclusion, suspension and expulsion of all students from school. The Education Act also applies to international students.

Refund of Tuition Fees

  1. If you withdraw from your course of study before the course completion date, you may be eligible for a partial refund of school fees.
  2. An application for refund of fees must be made in writing. Your parents must write to the Board of Trustees explaining why you have withdrawn from the course and your reasons for seeking a refund.
  3. If your application is made before the start of your course, your tuition and homestay fees will be refunded less a cancellation charge of $600 to cover costs incurred by the school.
  4. If your application is made after the start of your course, but before eight school weeks, your fees will be refunded less:
    • A cancellation charge of $600
    • Any commission paid to your agent
    • The proportion of the Government Levy the school is required to pay
    • 60% of the remainder of the tuition fee (this covers costs already incurred and committed to for the duration of the programme for the use of facilities, resources and salaries of teachers and support staff).
  5. No refund will be made to a student who is expelled from the school by the Board of Trustees.
  6. No refund will be made to a student enrolled who becomes a permanent resident.
  7. Administration fee will not be refunded.

Refund of Homestay Fees

  1. Early end of the course will have homestay fees for the future weeks refunded.
  2. If you move out of your homestay before the end of your contract, the portion of your homestay fees not already used will be returned to you. The Administration Fee will not be refunded.
  3. If you cancel your homestay contract before you move into the homestay, your fees will be refunded in full less the administration fee.
  4. If you request a change of homestay, then the original homestay will receive two weeks’ fees in lieu of notice.

Code of Practice for the Pastoral Care of International Students

Cullinane College has agreed to observe and be bound by the Code of Practice for the Pastoral Care of International Students published by the Minister of Education. Copies of the Code are available on request from this institution or from the New Zealand Ministry of Education website at nzqa.govt.nz/providers-partners/education-code-of-practice.

Dispute Resolution Scheme

As an approved institution of the Code of Practice, Cullinane is also bound by the Disputes Resolution Scheme (DRS) rules and bound by any decision made by the DRS operator, Fairway Resolution Ltd. If you require assistance to resolve a compliant with Cullinane College, please follow the procedure and Information about Fairway Resolution can be found online at istudent.org.nz.

Eligibility for Health Services

Most 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 health.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 acc.co.nz.

Medical and Travel Insurance

We require that all international students at Cullinane College have insurance that will cover the cost of any medical treatment and the loss of personal effects for the duration of their stay in New Zealand. The school is able to purchase a comprehensive policy from Unicare. If a student has alternative travel insurance, then please provide details of this policy for our records.

Immigration

Full details of visa and permit requirements, advice on rights to employment in New Zealand while studying, and reporting requirements are available through the New Zealand Immigration Service, and can be viewed on their website at immigration.govt.nz/new-zealand-visas.

I have read and understood these conditions applying to entry to Cullinane College. I agree to notify Cullinane College of any contact detail changes.

Cybersafety & E-Learning Programmes BYOD (Bring Your Own Device)

Cybersaftey - Agreement Declaration

As a signatory of this Agreement we recommend that you carefully read and discuss the stated rules related to Cybersafety with your child before signing this Agreement.

Confidentiality:

I will use my own username and password at all times.

As a signatory of this agreement I will:

  1. Only use the Internet at school if I sign and hand in this Cybersafety Use Agreement Form.
  2. Not connect any physical or electronic device to the school computers without teacher permission.
  3. Not use VPNs or similar software to bypass network restrictions and I will only use the BYOD wireless connection.
  4. Not use the Internet to access sites which could contain information that may be harmful to myself or the school network.
  5. Not use electronic media to bully others.
  6. Tell the teacher if I come across any problem, something that could be considered inappropriate or if I am not feeling safe.

Consequence of breaking this Agreement:

I understand that if I break this agreement there will be appropriate consequences that will be decided by the Senior Management Team.

E-Learning Programmes BYOD

We encourage a BYOD approach to education. Please Be aware of the following:

Security and Damages:

Responsibility to keep the device secure rests with the individual owner. The Cullinane College System, nor its staff or employees, is not liable for any device stolen or damaged on campus.

BYOD Cullinane College Student Agreement:

  1. The use of technology to provide educational material is not a necessity but a privilege. A student does not have the right to use his or her laptop, cell phone or other electronic device while at school.
  2. Students participating in BYOD must adhere to the ‘Cybersafety - Agreement Declaration’.
  3. Technology must be in silent mode while on school campuses and while riding school buses.

Student Statement:

In signing this Enrolment Form I consent to the ‘Cybersafety - Agreement Declaration’.

Parental Statement:

I have read and understood the school policies, Cybersafety & E-Learning Programmes BYOD and that he/she will conform to this agreement. In the event of any breach of this agreement, I will assist the College with any measure taken to resolve that issue.

Student Declaration

I have read and understood the conditions of being an international student at Cullinane College and agree to abide by the rules of the school:

  • The student’s parent guarantees the good behaviour of the student in New Zealand. He/she understands that behaviour which is unacceptable to the school as outlined in the Code of Conduct nzqa.govt.nz/providers-partners/education-code-of-practice/ or to homestay parents may lead to termination of the student’s enrolment at Cullinane College.
  • Unacceptable behaviour” includes the abuse of alcohol and drugs, theft, physical violence, or any action that contravenes New Zealand law. In the event of such misbehaviour, any decision made by the Principal and / or Board of Trustees will be regarded as final.
  • The student’s parent accepts the right of the school to effect a change of course if this is seen to be in the best interests of the student.
  • The student’s parent has read and understood the Cullinane College Refunds Policy for International Students.
  • The student’s parent understands the student may not own or drive a vehicle whilst a student at Cullinane College. Driving lessons with an approved professional driving school can be arranged through the director.
  • The student’s parent agrees that the student should attempt to speak English at all times on campus and at his/her homestay.
  • The student’s parent agrees that their son/daughter should take part in at least two out-of-school activities each year, for example, music, speech or sport.
  • The student’s parent understands that the Principal, Director or Homestay Parents have the authority to make decisions regarding medical treatment for their son/daughter. The student’s parent understands that they will be informed immediately in the case of an urgent problem.

If I am living in a homestay organised by Cullinane College. I agree to abide by the homestay rules and guidelines and to do my best to fit in with the lifestyle of my homestay family.

Note: 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 signatures from the correct people are included.

Student Name*
Clear Signature
Mother's Name
Clear Signature
Father's Name
Clear Signature

If you relied on a translator to understand this document, please ask the translator to sign here.

Translator's Name
Clear Signature

CONTACT

Ph: 06 349 0105
Fax: 06 343 8247

LOCATION

15 Peat Street,
Whanganui,
New Zealand

SCHOOL HOURS

Mon – Fri: 8:00am – 4:00pm
Weekends: Closed

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