Page 43 - Programme Information 2019 Chile

English Teaching College

International Student Application Form
Personal Details of Student

Family Name:
First Name(s):
Date of Birth: ___ / ___ / ___ Age: Gender: Male Female

Present Citizenship or Nationality: Present Occupation:
Passport Number: Passport Expiry Date:
First Language: Other Languages:

Home Address in New Zealand (if known) Address in Home Country

Phone Phone

Mobile Mobile
Email Email
Students must notify ETC when they change their address.
Please provide ETC with parents’ e-mail and phone number if students are under 18.
English Level

Beginner Elementary Pre-Intermediate (Able to write and spell to reasonable standard)
Lower-Intermediate (Equivalent to IELTS 4.5) Intermediate (Equivalent to IELTS 5.5)
Upper-Intermediate (Equivalent to IELTS 6.0) Advanced (Equivalent to IELTS 6.5 or higher)

Have you sat any English tests? PTE FCE CAE TOEIC IELTS

If Yes: Please provide detail (Score: W____ R____ L____ S_____ Overall ____)

Highest level of qualifications:
Year obtained:

Course Information
Campus Site: Palmerston North Wellington Lower Hutt
Course Name:
General English Academic English IELTS Preparation FCE/CAE Preparation
TOEIC High School Holiday Programme
Start Date: End Date: Number of study Weeks: weeks
Application to study: Full time Parts time morning Part time afternoon
What are your career plans after studying at ETC?

If you have studied in New Zealand, please supply your Academic Report & Attendance Record.
If you have a medical condition or disability, please supply details.
If the applicant is an agent please provide name and contact details.

Wellington Campus |TOEIC ETS Authorised Testing Centre | Level 2, 204 Willis Street |PO BOX 9787|Wellington 6141 | Phone: +64 4 385 0066|
Lower Hutt Campus | Level 3, 92 Queens Drive | Lower Hutt 5010 | Phone:+64 4 974 9984 | lowerhutt@etc.ac.nz
Palmerston North | 140-144 The Square | PO Box 995|Palmerston North 4410 | Phone: +64 6 357 7107||office@etc.ac.nz| Head Office