HOW TO APPLY

• Print this form and complete it as a hard copy. • Send the completed form to Study Options, 83 Alma Road, Clifton, Bristol, BS8 2DP,

with your supporting documents.

Supporting documents required for application:

1. A photocopy of the personal details page of your passport 2. Original certificates for your school (and any other) academic qualifications, for

example, GCSE, A Level, BTEC Diploma 3. Original certificates for any professional qualifications you would like included in the

assessment 4. A copy of your CV

Application fees

Study Options can waive applications fees for qualified candidates, so please do not enter any payment or card details on this form.

Application notes

1. If any further material or documents are required for your application, Study Options will be in touch to request these after we have received and checked your application.

2. All academic documents must be submitted as originals, we can’t accept photocopies. We’ll make certified copies to send with your application, and will return the originals by recorded delivery. To ensure their safe arrival, please send your documents to us by recorded delivery.

If you have any questions or problems making your application please contact a student advisor at Study Options on 020 7353 7200 or mail@studyoptions.com

PERSONAL DETAILS >Surname Title Mr Mrs Miss Ms

First Name Other title, please state below

Middle Names

Preferred Name Gender M F

Previous Surname if different Date of Birth

Passport Number Issuing Country

Passport Expiry Date

Home Address

Postcode

Mobile Telephone Number Telephone Number

Email

Term AddressIf known

Postcode

Mobile Telephone Number Telephone Number

Email

WHO SHOULD WE CONTACT IN CASE OF EMERGENCY?

Emergency Contact Person Relationship

Emergency Contact Number Email

AGENT DETAILS (if applicable) >

Counsellor Name Agent Stamp

Company Name

Address

Postcode

Mobile Telephone Number Telephone Number

Email

Please complete ALL sections, in English, by printing in CAPITAL LETTERS. Scan and email the application form and DFSUJÝFE�DPQJFT�PG�BMM�SFRVJSFE�EPDVNFOUT�UP��international@nmit.ac.nz or mail to the address at the end of this form.

Results will be sent to your home address, unless otherwise advised

KIA ORA! Thank you for choosing to study with Nelson Marlborough Institute of Technology (NMIT)

International Application/Enrolment Form

Stefan WattsStudy Options83 Alma RoadBristol

BS8 2DP+44 7771 798043

mail@studyoptions.com

PROGRAMME OF STUDY >*�XJTI�UP�TUVEZ�UIF�GPMMPXJOH�RVBMJÝDBUJPO�

Programme Name

Start Date Month Year

Venue Nelson Marlborough Woodbourne

If applying for English Language select intake date (please refer to nmit.ac.nz�GPS�&OHMJTI�-BOHVBHF�JOUBLF�EBUFT�

Intake Date Number of weeks of study (minimum of two weeks)

ACADEMIC QUALIFICATIONS >1MFBTF�JODMVEF�DFSUJÝFE�DPQJFT�PG�CPUI�ZPVS�TFDPOEBSZ�BOE�UFSUJBSZ�BDBEFNJD�USBOTDSJQUT�BOE�ZPVS�ÝOBM�BXBSE�

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Name of institution Country

ENGLISH LANGUAGE PROFICIENCY

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IELTS Overall Score Date of Assessment

TOEFL Overall Score Date of Assessment

FCE Overall Score Date of Assessment

ACCOMMODATION REQUIREMENTS >A NZD$250.00 non-refundable application fee applies. Please refer to http://www.nmit.ac.nz/international/accommodation for accommodation information.

I will make my own accommodation arrangements Yes No

I would like to stay at Nikau Apartments (Nelson only) Yes No

I would like Full Homestay Yes No

I would like Independent Homestay Yes No

I would like help with other accommodation options Yes No

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STUDENT SUPPORT/MEDICAL DETAILS >Do you wish to be contacted by one of the following support staff?

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MARKETING INFORMATION >

How did you hear about Nelson Marlborough Institute of Technology (NMIT)?

� 'SJFOET�GBNJMZ� /.*5�JOUFSOBUJPOBM�BHFOU� � /.*5�XFCTJUF

� )JHI�TDIPPM�DPMMFHF�UFBDIFS� /.*5�QSFTFOUBUJPO�BU�IJHI�TDIPPM�DPMMFHF� � 0OMJOF�BEWFSUJTJOH���'BDFCPPL"ET

Newspaper NMIT publication (brochure or prospectus) Online advertising - GoogleAds

NMIT email promotion NMIT student (previous or current) Online advertising - You Tube

MEDICAL AND TRAVEL INSURANCE >5IF�/FX�;FBMBOE�.JOJTUSZ�PG�&EVDBUJPO �UISPVHI�UIF�$PEF�PG�1SBDUJDF�GPS�UIF�1BTUPSBM�$BSF�PG�*OUFSOBUJPOBM�4UVEFOUT �SFRVJSFT�UIBU�BMM�*OUFSOBUJPOBM�4UVEFOUT�NVTU�IBWF�BQQSPQSJBUF�medical and travel insurance for the duration of their planned study in New Zealand. For more information please visit minedu.govt.nz.

NMIT will automatically arrange insurance coverage for all students. Students can choose their own insurance company, however it must comply with the minimum standards SFRVJSFE�CZ�UIF�$PEF�PG�1SBDUJDF�GPS�UIF�1BTUPSBM�$BSF�PG�*OUFSOBUJPOBM�TUVEFOUT��*G�ZPV�BSSBOHF�ZPVS�PXO�JOTVSBODF�DPWFS �ZPV�NVTU�TVQQMZ�ZPVS�$FSUJÝDBUF�PG�*OTVSBODF�BOE�4DIFEVMF�PG�$PWFS �JO�&OHMJTI �UP�UIF�*OGPSNBUJPO�BOE�&OSPMNFOU�$FOUSF��0ODF�UIF�JOTVSBODF�QPMJDZ�JT�FWBMVBUFE�BOE�DPOÝSNFE�BT�NFFUJOH�UIF�NJOJNVN�TUBOEBSET�SFRVJSFE�CZ�UIF�$PEF�PG�Practice for Pastoral Care the policy taken out by NMIT on behalf of the student will be cancelled with the fees refunded to the student. Please be aware that if you do not provide B�TBUJTGBDUPSZ�JOTVSBODF�QPMJDZ �ZPV�XJMM�CF�SFRVJSFE�UP�UBLF�PVU�B�EFGBVMU�QPMJDZ�QSJPS�UP�DPNNFODJOH�UIF�TUVEZ�QSPHSBNNF�

/.*5�IBT�BSSBOHFNFOUT�XJUI�.BSTI�-UE� JO�BTTPDJBUJPO�XJUI�7FSP�B�/FX�;FBMBOE�CBTFE�QSPWJEFS�XIP�IBT� TQFDJÝD�QPMJDJFT� GPS� *OUFSOBUJPOBM�4UVEFOUT��5IF�QPMJDZ� JT� DBMMFE�Studentsafe. More information about Studentsafe can be found by following this link on the NMIT website at nmit.ac.nz/international/helpfuladvice. Once we receive payment of the insurance fee, your insurance will be arranged. The commencement date of your policy will be set to the date you depart for New Zealand.

I would like NMIT’s insurance cover Yes No

DECLARATION >The Nelson Marlborough Institute of Technology (NMIT) has agreed to observe and be bound by the Code of Practice for the Pastoral Care of International Students published by the /FX�;FBMBOE�.JOJTUSZ�PG�&EVDBUJPO��$PQJFT�PG�UIF�DPEF�BSF�BWBJMBCMF�CZ�SFRVFTU�GSPN�/.*5�PS�GSPN�UIF�/FX�;FBMBOE�.JOJTUSZ�PG�&EVDBUJPO�XFCTJUF�BU�minedu.govt.nz.

I agree that if the International Student Advisor has concerns regarding my welfare, safety or behaviour, after discussing them with me they can contact my parents, guardians or educational agent to discuss appropriate courses of action.

I agree to abide by the conditions described above, and I consent to the disclosure of personal information as described above.

I understand that if I have supplied false information or do not comply with the rules and regulations of NMIT, my Offer of Place may be cancelled.

I have read and understood the International Student Fees, Charges and Refunds conditions in the International Prospectus.

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Signature Date

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Signature Date

If you have a query regarding your application, we are happy to help. Please contact us >

Phone > +64 3 546 9175 Fax > +64 3 546 3325Email > international@nmit.ac.nz nmit.ac.nz

FOR OFFICE USE ONLY > Signature (Enrolments)

Date

Your application will be processed ONLY when we have received all required documentation.

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Photocopy of your passport

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APPLICATION SUBMISSION >&NBJM�ZPVS�TDBOOFE�BOE�DPNQMFUFE�BQQMJDBUJPO�GPSN�JODMVEJOH�TDBOOFE�DPQJFT�PG�BMM�SFRVJSFE�EPDVNFOUBUJPO�UP��international@nmit.ac.nz

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Nelson Marlborough Institute of Technology

International Information and EnrolmentsPrivate Bag 19, Nelson 7042New Zealand

Telephone > +64 3 546 9175 I Fax > +64 3 546 3325 I Email > international@nmit.ac.nz

THANK YOU

APPLICATION CHECKLIST >

We look forward to welcoming you to NMIT soon.

STUDENT DECLARATION Name:

Date of birth:

Nationality:

Address:

Telephone number:

Email address:

Who will fund your tuition fees and living costs? Please give further details below:

• I declare that I have read and understand the information relating to the cost of living in New

Zealand at: http://www.immigration.govt.nz/migrant/stream/study/canistudyinnewzealand/whatisrequired/financialreqs.htm and I have access to sufficient funds to cover all associated costs with my study, travel to and from New Zealand, living expenses for the duration of my studies for myself and my family members (if applicable) for the total period of my stay in New Zealand.

• I understand that the tuition fees do not include expenses such as textbooks, stationery and additional program specific requirements.

• I understand that in the event that I have insufficient funds to cover all associated study and living costs, I will not seek assistance from the College or the Australian or New Zealand government.

• I understand that in the event that I have insufficient funds to cover all associated study and living costs, the College reserves the rights to terminate my enrolment and eCoE.

• I hereby certify that all the statements made on this declaration of finances are true and correct.

Student signature:

Date:

Please return this declaration with your application form(s)