OFFICE USE ONLY: Approved
Date: day / month / year
C onditional Signed:
International Student Application Form Please use a pen and complete in English PLEASE COMPLETE ALL SECTIONS OF THIS FORM THAT APPLY TO YOU AND SEND TOGETHER WITH ALL DOCUMENTS You must include: • A completed application form • Official documentation of your academic results. All documents must be notarised/certified and translated into English. • A notarised/certified copy of your passport details • If your first language is not English, you must also include supporting evidence of your English proficiency. Please see the English Language Proficiency and Study section of this application form for more information
Personal Information Mr
Surname/Family name (as shown on your passport) First name/Given name (as shown on your passport) Preferred Name Gender
Date of birth
day / month year /
Are you under 18 years of age?
Contact Information Home country postal Address
New zealand Address while studying (if known)
Accommodation Type NZ Mobile phone
NZ Home phone
EMERGENCY CONTACT DETAILS (if you are under 18 years of age, this must be a parent or legal guardian) Full Name Do they speak English? Yes
Relationship to you No
English Language Proficiency and Study To study at Bay of Plenty Polytechnic, you MUST be proficient in English. Please provide evidence of the following:
I will sit/have sat an IELTS, TOEFL, NZCEL test or University of Cambridge Examinations, a Pearson test of English (Academic) or City and Guilds IESOL - in accordance with the TABLE for Internationally recognised English Proficiency Outcomes for International Students listed by the New Zealand Qualifications Authority (http://goo.gl/A4y9hi) http://www.nzqa.govt.nz/about-us/our-role/legislation/nzqa-rules/nzqf-related-rules/programme-approval-and-accreditation/app-2/the-table/
/ month year / Date taken/to be taken day
English test name
Results (if known)
I have studied at a New Zealand Secondary School and have gained NCEA Level 3 and New Zealand University entrance
/ month year / Date taken/to be taken day
Results (if known)
English is the language of instruction in my previous studies - completion of all primary education and at least three years of secondary education (that is, the equivalent of New Zealand Forms 3 to 7 or years 9 to 13) at schools using English as the language of instruction - completion of at least five years of secondary education (that is, the equivalent of New Zealand Forms 3 to 7 or years 9 to 13) at schools using English as the language of instruction - completion of a tertiary qualification of at least three years’ duration with English as the language of instruction in New Zealand, Australia, Canada, the Republic of Ireland, South Africa, the United Kingdom or the United States
I have achieved the Certificate of English Language Teaching to Adults I would like to apply for an English Language programme
Programme of Academic Study See the International Prospectus for programme names, intake dates, and entry requirements. If you do not meet the academic entry requirements, we will automatically assess your eligibility for a pathway programme. If you do not meet the English language entry requirements, we will provide you with a Conditional Offer of Place. Name of the course(s) or programmes(s) you are applying for
Proposed start date
With pathway into another qualification? Yes
If yes, please indicate which qualification?
I wish to apply for the one-month Tools For Academic Study preparatory programme January
Career Intention (this section must be completed by ALL applicants) What is your intended career? Do you think your chosen qualification will help you fulfil your career intention? Yes
Secondary and Tertiary Education Do you have a current Student Visa to study in New Zealand? Yes
What is the highest academic qualification you hold from a secondary school? (Please attach copies) Qualification Name of School
/ month year / Date qualification was awarded day Have you ever enrolled in a university, college, institute of technology, polytechnic, Yes or other tertiary institution since leaving school?
If yes, please enter the year of your first enrolment Please list any university/polytechnic qualifications here (Please provide transcripts and completion certificates for all qualifications listed here) Name of qualification Name of institution
Year study began
Name of qualification Name of institution
Year study began
Name of qualification Name of institution
Year study began
Credit Transfer/Advanced Standing Are you applying for credit transfer for previous study? Yes
(Please provide verified copies of full official or academic transcripts and course descriptions/syllabus for all tertiary qualifications)
Agent Details Agent Stamp
Consultant / Counsellor Name: Company name: Address City
Funding Details If you are not self-funded please provide the name of your Scholarship Provider or Financial Guarantor here
Accommodation Do you need assistance with accommodation arrangements? Yes Do you need an airport shuttle pickup? Yes
Insurance Do you have travel and medical insurance? Yes
(If Yes, please attach a copy of your policy)
Do you need Bay or Plenty Polytechnic to arrange insurance for you? Yes
Ethnicity What ethnic group do you belong to? British/Irish 121
Other Pacific Island Groups
361 Fijian Other Southeast Asian
Disability Details This information below is confidential. The information provided is used for statistical purposes and to help support students with disabilities and/or medical conditions. Do you live with the effects of injury, long-term illness or disability? Yes
If yes, please name/describe your condition/disability? In the event of an emergency, would you need help to evacuate the building? Yes Do you require any additional resources to assist you in your studies? Yes
Bay of Plenty Polytechnic Information How did you find out about Bay of Plenty Polytechnic? International Advertisement
English Language School
OFFICE USE ONLY: Met with
Important Information Code of Practice for the Pastoral Care of International Students Bay of Plenty Polytechnic has agreed to observe and be bound by the Code of Practice for the Pastoral Care of International Students. Copies of the Code are available from the New Zealand Ministry of Education website at www.minedu.govt.nz/goto/international. IMMIGRATION Student Visas All students must meet the requirements of Immigration New Zealand to study in New Zealand. Full details of Immigration requirements, advice on rights to employment in New Zealand while studying and reporting requirements are available through the Immigration New Zealand (INZ) services and can be viewed on their website at www.immigration.govt.nz. MEDICAL AND TRAVEL INSURANCE Compulsory International students must have appropriate and current medical and travel insurance while studying in New Zealand. These are a requirement of the Code of Practice for the Pastoral care of International Students. Eligibility for Health Services in New Zealand Most International 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 www.moh.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 www.acc.co.nz. ORIENTATION All international students are required to attend an orientation session. Orientation is held either before the commencement of classes or on the week classes start in both semesters. During orientation students will familiarise themselves with Bay of Plenty Polytechnic’s campus and learn about resources available to make their study successful.
Fees and Costs International students are required to pay the appropriate tuition fee for the programme in which they are enrolled in. These fees are listed in the International Prospectus and online www.boppoly.ac.nz/ go/international/international-fees. Students are also required by Immigration New Zealand to have an additional NZ$15,000 for living expenses for each year of study. Fees Protection Policy The Polytechnic is protected by the Public Finance Act, the Education Act and the Polytechnic regulations in regard to student fees. An individual fee account is maintained for each enrolled student. Charges Bay of Plenty Polytechnic will charge late payment and debt collection charges on all unpaid accounts. Termination of Enrolment At the time of enrolment, students are required to sign an International Student Enrolment / Re-Enrolment Form (or if not available at the time of enrolment, a Student Detail and Enrolment Form or Student Re-enrolment Form) agreeing to abide by the regulations and policies of Bay of Plenty Polytechnic. The Student Regulations and Policies provide the framework for addressing alleged breaches of Polytechnic regulations by students and for applying penalties where breaches are substantiated. Full details of these regulations should be read and understood at the time of enrolment. Full details are available online at www.boppoly.ac.nz/go/international. Withdrawal & Refund of Fees See www.boppoly.ac.nz/go/international for current international fees and the Student Entry and Withdrawal, fees and refunds policy. When you sign the International Student Application Form and/or the International Student Enrolment / Re-Enrolment Form or the Student Detail & Enrolment Form or Student Re-enrolment Form you are signing a legally binding agreement. If you then choose to withdraw or not attend your programme of study, you must advise the appropriate Head of School. Fees will be charged as detailed below. 3.7.1 Cancellations 184.108.40.206 Bay of Plenty Polytechnic (BoPP) reserves the right to cancel a programme/course if there are insufficient enrolments prior to programme/course commencement.
220.127.116.11 If BoPP cancels or postpones a programme/course all international student fees will be refunded in full or credited to another course. 3.7.2 Withdrawals 18.104.22.168 An International student must complete an official International Student Withdrawal or Transfer Application form to withdraw and apply for a refund from any course that they are enrolled in. These forms are available from the International Office, Information Centre or relevant School reception. All applications must be submitted to the School, along with supporting written information. 22.214.171.124 The date of withdrawal will be taken from the date the completed International Student Withdrawal or Transfer Application form is received by the School. 3.7.3 Late Arrivals 126.96.36.199 If a student starts the course after the earliest course start date, the date of the withdrawal will be processed against the student commencement date which was agreed by BoPP. 3.7.4 Refunds 188.8.131.52 By accepting a place in a programme/ course at BoPP, a student enters a contract with BoPP for the period defined on the student visa. Any application for refund of tuition fees for study will be subject to the conditions outlined in this section. 184.108.40.206 Any refund will be calculated from the date the International Student Withdrawal or Transfer Application form is received by the school. Refund amounts can only be held in credit for the year the refund has been processed unless agreed in writing by the Director Academic. 220.127.116.11 Where New Zealand Immigration regulations require payment of one year’s tuition fee in order to be granted a visa or permit, there is no refund of tuition fees if a student does not complete the whole year of study. 18.104.22.168 There is no automatic right to a refund of fees if a student changes his/ her mind about studying at BoPP.
Important information continued overleaf
Important Information continued 3.7.5 International students will be eligible for a full refund if: a. BoPP declines or withdraws an offer of a place to a student. b. BoPP is unable to provide the programme offered. However BoPP will not be liable for any other costs. BoPP will offer an alternative programme/course where possible. c. An international student is declined an intial visa by New Zealand Immigration. In this case however $600 will be held for administration purposes. 3.7.6 International students will be eligible for a partial refund if: a. A formal withdrawal from the enrolment is received no later than 7 days prior to commencement of the programme of study, 90% of the fees will be refunded. b. Exceptional circumstances necessitate withdrawal from a programme of study after the period stated above (from 7 days before the programme/course start date). BoPP will consider the circumstances and approve a refund, less a $600 administration fee and agent commission where applicable. Information to support an exceptional circumstances claim must be supplied in writing. 3.7.7 Students will not be eligible for any refund if: a. Formal withdrawal is received after the date that the programme commences, unless there are exceptional circumstances. b. A student is withdrawn from study following academic or disciplinary procedures. c. A student is on a student visa and fails to enrol at BoPP. There will be no refund for the period the visa was granted once the earliest course start date of the student’s academic year has passed, unless there are exceptional circumstances. d. A student is refused an extension to an existing visa by Immigration New Zealand on the basis of poor attendance. c. An offer is withdrawn or BoPP declines to offer a place as a result of fraudulent information being supplied by the student. Fees set by external bodies 3.7.8 External examination fees will be refunded (less an administration charge of $50.00 including GST ) if an International Student Withdrawal or Transfer Application is received before the last date as set by BoPP each year. If fees have been sent to the examining body a request for refund must be made directly with the appropriate organisation within the publicised time frame.
Agent fees and commission 3.7.10 Bay of Plenty Polytechnic is not liable to compensate the student or repay the student any commission or fees the student paid any agent. Any fees the student has paid a recruitment agent will have to be claimed by the student from the agent. Any commission or fee paid by BoPP relating to the student’s recruitment, enrolment or accommodation will be deducted from the amount of any refund payable to the student. Refund arrangements 3.7.11 Bay of Plenty Polytechnic will not pay refunds directly to international students or their agents in New Zealand. Refunds are either sent to the institution to which the student is transferring, or to the account holder who paid the fees in their country of origin, after their Student Visa has been cancelled. 3.7.12 If a student has other fees owing to BoPP, those fees will be deducted from any refund. 3.7.13 A refund may take up to three weeks to be processed, except in the case of exceptional circumstances which may take longer. 3.7.14 In any case no refund less than $10.00 (including GST) will be made. Permanent Residency 3.7.15 An international student who gains permanent residency is entitled to be treated as a domestic student. They will not receive a refund of fees for the semester during which the Permanent Residency is granted. However, the student will be entitled to pay domestic fees for subsequent semesters that start after Permanent Residency was granted, and will be refunded any difference between domestic and international fees for those semesters. For non-semester courses, international fees are payable for the full year. If Permanent Residency is granted during the year, no part of the international fee for that year is refundable.
3.7.18 A $100.00 (including GST) administration fee will be charged for every approved transfer, in addition to any additional charges as a result of the difference in fees between the course transferring from and to. The fee is to be paid by the student before the transfer application is processed by the School. No transfer application will be processed until it has been approved by the relevant School/department and any outstanding fees have been paid. Transfers within Programmes at Bay of Plenty Polytechnic 3.7.19 Transfers may only be accepted within two weeks from the course start date. All applications will be considered for approval or declination by the relevant School. 3.7.20 A $20.00 (including GST) administration fee may be charged for each transfer initiated by a student between courses and/or semesters/terms (this does not include between the same course within the same enrolment period i.e. classes), in addition to any additional charges as a result of the difference in fees between the course transferring from and to. The administration fee may be charged at the discretion of the relevant Head of School. 3.7.21 If an administration fee is charged, the fee is to be paid by the student before the transfer application can be processed by the School. No transfer application will be processed until it has been approved by the relevant School and any outstanding fees have been paid.
Transfers Between Programmes at Bay of Plenty Polytechnic 3.7.16 Transfers may only be accepted within two weeks from the course start date. All applications will be considered for approval or declination by the relevant School, however notification and prior approval of any programme change must also be sort from immigration; before any change can be approved. 3.7.17 The international student must pay any direct costs incurred by the original School e.g. equipment, uniforms, books.
3.7.9 Refund of any New Zealand Qualification Authority Unit credit fees will be made in full, but only in circumstances where a refund for the relevant subject is processed. Please ensure you sign the declaration over the page
Declaration I declare that the information I have provided in this application and in any attached documentation is true and correct and that I have personally completed the form. I have not withheld any information, which could have a bearing on my enrolment or the conditions of my enrolment. I acknowledge, understand and accept by signing this declaration: 1. The documents submitted with this application become the property of Bay of Plenty Polytechnic and will not be returned to applicants. 2. I agree to supply any further documentation requested by the Bay of Plenty Polytechnic for the purpose of my enrolment. 3. I acknowledge that Bay of Plenty Polytechnic may cancel my enrolment if false information has been supplied, or required information is not supplied by the due date. 4. I am accepting Bay of Plenty Polytechnic’s (the Polytechnic’s) offer of a place in the specified programme(s) subject to the terms and conditions set out in this International Student Application Form, and Student Regulations and Policies detailed on our website www.boppoly.ac.nz under Student Services, Student Info, Concerns, Complains & Policies. 5. I have read and understood the Student Entry and Withdrawal, fees and refunds policy 6. I am liable for the fees payable for my programme of study upon signing this International Student Application Form. All fees and outstanding Polytechnic debts must be paid in full prior to programme commencement. The Polytechnic may take such steps to recover any outstanding fees as may be necessary. 7. The Polytechnic has the right to: • Cancel programmes and to limit student numbers in any programme.
• Cancel this agreement if I breach any of its terms and conditions and to offer my place to someone else. This is without prejudice to any other rights or remedies the Polytechnic might have against me. • Cancel, postpone or reschedule classes without notice, or otherwise vary this agreement if the variation is caused by a reason beyond its control including but without limitation, prevention from or hindrance in obtaining materials or supplies, employment issues and/or disputes of whatever nature, act of God, fire, act of Government or state, social or political unrest, or war. 8. I authorise the Polytechnic to collect, use and disclose information about me in accordance with the Privacy Act 1993 and as set out on our website www.boppoly.ac.nz under Student Services, Student Info, Concerns, Complains & Policies. 9. I agree that before using Electronic Information Resources (computers, Internet, e-mail) at the Polytechnic I will read and abide by the conditions and guidelines contained in the Electronic Information Resource Agreement as set out on our website www.boppoly.ac.nz under Student Services, Student Info, Concerns, Complains & Policies. I have read the terms and conditions contained in this agreement, those set out in the documents referred to, and I accept the Polytechnic’s offer on these terms and conditions. I declare that the information I have provided on this form is true and correct.
Full Name Date
/ month year / day
day / month year /
Signed If Student under 18 years of age Parent or Caregivers signature Full Name
Where Do I Send My Application? Postal address: International Admissions Bay of Plenty Polytechnic Private Bag 12001 Tauranga 3143 New Zealand
Courier address: International Admissions Bay of Plenty Polytechnic 70 Windermere Drive, Poike Tauranga 3112 New Zealand
Scan and email to: [email protected]
Facsimile +64 7 578 0656
Bay of Plenty Polytechnic Phone +64 7 571 0190 | www.boppoly.ac.nz/go/international | [email protected]