{{/* Application Form Example - See https://golang.org/pkg/text/template/ for syntax. Template params are automatically escaped. */}} {{school "Name"}} Signup Form

{{school "Name"}} Signup Form

{{/* These two input tags are critical to eSchool signups - Don't touch */}} {{if .MissingRequired}}
Submission Error

There was a problem submitting your form. The following required fields were not filled in:

    {{range .MissingRequired}}
  • {{replace . "_" " "}}
  • {{end}}
{{end}}

Fields marked with{{template "required"}} are required.

Student Details
First name (as on passport)
{{template "inputText" required "First_Name"}}
Middle names (as on passport)
{{template "inputText" optional "Middle_Names"}}
Last name (as on passport)
{{template "inputText" required "Family_Name"}}
Preferred first name
{{template "inputText" optional "Preferred_Name"}}
Date of Birth
{{template "inputDate" required "Birth_Date" (rangeStr (plus ((now).Year) -20) 15)}}
Country of Birth
{{template "inputLineSelect" required "Country_Of_Birth" (school "Country_List")}}
Gender
{{template "inputRadios" required "Gender" "Male,Female"}}
Ethnicity
{{template "inputLineSelect" required "Ethnicity_1" (school "Ethnicity_List")}}
First Language
{{template "inputLineSelect" required "First_Language" (school "Language_List")}}
Overseas Address
{{template "inputText" required "Overseas_Address_1"}}
{{template "inputText" optional "Overseas_Address_2"}}
{{template "inputText" optional "Overseas_Address_3"}}
{{template "inputText" optional "Overseas_Address_4"}}
{{template "inputTextPlaceholder" optional "Overseas_Post_Code" "Postcode"}}
{{template "inputLineSelect" required "Overseas_Country" (school "Country_List")}}
Overseas phone number
{{template "inputIntPhone" optional "Overseas_Phone_Number"}}
New Zealand mobile number
{{template "inputText" optional "Local_Mobile_Number"}}
Email address
{{template "inputText" optional "Email_Address"}}
How long have you studied English
{{template "inputSelect" optional "WEB_Studied_English_For_Years" (rangeStr 0 20)}}Years {{template "inputSelect" optional "WEB_Studied_English_For_Months" (rangeStr 0 11)}}Months
{{/*
IELTS (International English Language Testing System) Score
{{template "inputSelect" optional "WEB_IELTS_Level" "0,0.5,1,1.5,2,2.5,3,3.5,4,4.5,5,5.5,6,6.5,7,7.5,8,8.5,9"}}
*/}}
Sporting Interests
{{template "inputLineChecks" optional "Interests_Sporting" (school "Sporting_List")}}Other:
{{template "inputArea" optional "Sports_Other"}}
Cultural Interests
{{template "inputLineChecks" optional "Interests_Cultural" (school "Cultural_List")}}Other:
{{template "inputArea" optional "Cultural_Other"}}
Agent Details (Only applicable if you are an agent)
Name
{{template "inputText" optional "Agent_Name"}}
{{/*
Id (as provided by {{school "Name"}})
{{template "inputText" optional "Agent_ID"}}
*/}}
Email
{{template "inputText" optional "Agent_Email"}}
Previous Applications
What was the name of the last school you attended?
{{template "inputText" optional "Previous_School"}}
Have you applied to {{school "Name"}} before?
{{template "inputRadios" optional "WEB_Applied_Before" "Yes,No"}}
If yes, when?
{{template "inputDate" optional "WEB_Prev_Application_Date" (rangeStr (plus ((now).Year) -20) 20)}}
Have you studied in New Zealand before?
{{template "inputRadios" optional "WEB_Studied_In_NZ_Before" "Yes,No"}}
If yes, please state which school
{{template "inputText" optional "WEB_Prev_NZ_School"}}
Has your brother or sister enrolled at {{school "Name"}} before?
{{template "inputRadios" optional "WEB_Sibling_Enrolled_Before" "Yes,No"}}
Name
{{template "inputText" optional "WEB_Siblings_Name"}}
Year Attended
{{template "inputText" optional "WEB_Siblings_Year_of_Study"}}
Travel Details
Arrival date (if available)
{{template "inputDate" optional "NZ_Arrival_Date" (rangeStr ((now).Year) 1)}}
Passport number
{{template "inputText" preferred "Passport_Number"}}
Passport expiry
{{template "inputDate" preferred "Passport_Expiry_Date" (rangeStr ((now).Year) 10)}}
Student Visa number
{{template "inputText" optional "Visa_Number"}}
Student Visa issued
{{template "inputDate" optional "Visa_Issue_Date" (rangeStr ((now).Year) 1)}}
Student Visa expiry
{{template "inputDate" optional "Visa_Expiry_Date" (rangeStr ((now).Year) 5)}}
Parents/Caregivers Details
Mother/Caregiver 1 Details:
First name
{{template "inputText" preferred "CG_1_First_Name"}}
Middle names
{{template "inputText" preferred "CG_1_Middle_Names"}}
Last name
{{template "inputText" preferred "CG_1_Family_Name"}}
Relationship (Mother,Father,Aunt,Guardian)
{{template "inputText" preferred "CG_1_Relationship"}}
Occupation
{{template "inputText" preferred "CG_1_Occupation"}}
Overseas address
{{template "inputText" optional "CG_1_Address_1"}}
{{template "inputText" optional "CG_1_Address_2"}}
{{template "inputText" optional "CG_1_Address_3"}}
{{template "inputText" optional "CG_1_Address_4"}}
{{template "inputTextPlaceholder" optional "CG_1_Post_Code" "Postcode"}}
Phone number
{{template "inputIntPhone" preferred "CG_1_Phone_Number"}}
Work number
{{template "inputIntPhone" optional "CG_1_Work_Number"}}
Mobile number
{{template "inputIntPhone" optional "CG_1_Mobile_Number"}}
Email address
{{template "inputText" preferred "CG_1_Email_Address"}}
Father/Caregiver 2 Details:
First name
{{template "inputText" optional "CG_2_First_Name"}}
Middle names
{{template "inputText" optional "CG_2_Middle_Names"}}
Last name
{{template "inputText" optional "CG_2_Family_Name"}}
Relationship (Mother,Father,Aunt,Guardian)
{{template "inputText" optional "CG_2_Relationship"}}
Occupation
{{template "inputText" optional "CG_2_Occupation"}}
Overseas address
{{template "inputText" optional "CG_2_Address_1"}}
{{template "inputText" optional "CG_2_Address_2"}}
{{template "inputText" optional "CG_2_Address_3"}}
{{template "inputText" optional "CG_2_Address_4"}}
{{template "inputTextPlaceholder" optional "CG_2_Post_Code" "Postcode"}}
Phone number
{{template "inputIntPhone" optional "CG_2_Phone_Number"}}
Work number
{{template "inputIntPhone" optional "CG_2_Work_Number"}}
Mobile number
{{template "inputIntPhone" optional "CG_2_Mobile_Number"}}
Email address
{{template "inputText" optional "CG_2_Email_Address"}}
Accommodation Details {{$stay := optional "Homestay_Destination"}}
Where will you be staying?{{template "required"}}
{{$opt := "Homestay organised by school"}}
Homestay Information
Letter to Homestay
Please paste in a short letter (below) to introduce yourself to your new host family. Tell them what you like, why you're coming to New Zealand any anything else you want them to know.
{{template "inputAreaLarge" optional "Homestay_Letter"}}
Important Homestay Considerations
Please include any important homestay requirements, such as vegetarian, or that you are allergic to cats etc. This information is used to help us choose the best homestay for you.
{{template "inputAreaLarge" optional "Homestay_Considerations"}}
{{$opt2 := "Designated Caregiver"}}
Parent/Designated Caregiver (DCG) Details
First name
{{template "inputText" optional "CG_3_First_Name"}}
Middle names
{{template "inputText" optional "CG_3_Middle_Names"}}
Last name
{{template "inputText" optional "CG_3_Family_Name"}}
Relationship (Mother,Father,Aunt,Guardian)
{{template "inputText" optional "CG_3_Relationship"}}
Occupation
{{template "inputText" optional "CG_3_Occupation"}}
Overseas address
{{template "inputText" optional "CG_3_Address_1"}}
{{template "inputText" optional "CG_3_Address_2"}}
{{template "inputText" optional "CG_3_Address_3"}}
{{template "inputText" optional "CG_3_Address_4"}}
{{template "inputTextPlaceholder" optional "CG_3_Post_Code" "Postcode"}}
Phone number
{{template "inputText" optional "CG_3_Phone_Number"}}
Work number
{{template "inputText" optional "CG_3_Work_Number"}}
Mobile number
{{template "inputText" optional "CG_3_Mobile_Number"}}
Email address
{{template "inputText" optional "CG_3_Email_Address"}}

Please note: A DCG must be a relative or close family friend of the family. This accommodation must be approved by {{school "Name"}} prior to the student's arrival. Please provide a copy of the passport (and visa if applicable).

{{$opt3 := "Parents"}}
Medical Details {{$declaration := required "Insurance_Declaration"}}
Do you wish to purchase insurance through the school? {{template "required"}}

Insurance must cover travel and health for entire length of stay in New Zealand as per school's terms and conditions.

Insurance company
{{template "inputText" optional "Insurance_Company"}}
Insurance policy number
{{template "inputText" optional "Insurance_Policy_Number"}}
Insurance policy expiry
{{template "inputDate" optional "Insurance_Policy_Expiry_Date" (rangeStr ((now).Year) 4)}}
Medical Information
You must declare all medical details. Withholding information may result in your contract being terminated.
{{template "inputArea" optional "Medical_Info"}}
The school WILL dispense any over the counter medications as it sees fit to students UNLESS specified above.
Current Medications
{{template "inputArea" optional "Medications"}}
Allergies
{{template "inputArea" optional "Allergies"}}
Doctor name (in home country)
{{template "inputText" optional "Doctor_Name"}}
Doctor phone
{{template "inputIntPhone" optional "Doctor_Phone"}}
Emergency Contact (If other than parent)
First name
{{template "inputText" optional "Emergency_Contact_First_Name"}}
Family name
{{template "inputText" optional "Emergency_Contact_Family_Name"}}
Relationship
{{template "inputText" optional "Emergency_Contact_Relationship"}}
Phone number
{{template "inputIntPhone" optional "Emergency_Contact_Phone_Number"}}
Address
{{template "inputArea" optional "Emergency_Contact_Address"}}
Email address
{{template "inputText" optional "Emergency_Email_Address"}}
Course Details
Study Programme
{{template "inputLineRadios" optional "Examining_Body" (school "Examining_Body_List")}}
When will you start?
Year {{template "inputSelect" optional "Start_Year" (rangeStr (((now).Year)) 4)}} Term {{template "inputSelect" optional "Start_Term" "1,2,3,4"}}
Duration of study?
{{template "inputSelect" optional "Number_Of_Terms" (rangeStr 1 15)}} Terms
{{if school "Course_Guidance"}}

{{html (paragraph (school "Course_Guidance") "

")}}

{{end}} {{$year := optional "Year"}}
Year/Subjects{{if $year.Required}}{{template "required"}}{{end}}
{{range split "9,10,11,12,13" ","}} {{$y := .}} {{$subjects := school (concat "Year_" . "_Subjects")}} {{if $subjects}} {{$s := optional "Subjects" $subjects}}
{{if eq $year.Value .}}{{template "inputLineChecks" $s}} {{else}} {{range $i,$v := linesplit $subjects}} {{end}} {{end}}
{{end}}{{end}}
Learning Difficulties
You must declare any learning difficulties you may have. Failure to notify of any difficulties may result in your enrolment being terminated.
{{template "inputArea" optional "Medical_Special_Needs"}}
Comments
Is there anything you would like to tell us?
{{template "inputArea" optional "Comments"}}
Declarations

Full terms and conditions can be found here.

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

{{/*
Student Declaration {{template "iAgreeDeclaration" required "WEB_Declaration_1" (school "WEB_Declaration_1")}}
{{template "iAgreeDeclaration" required "WEB_Declaration_2" (school "WEB_Declaration_2")}}
Parent/Caregiver Declaration {{template "iAgreeDeclaration" required "WEB_Declaration_3" (school "WEB_Declaration_3")}}
{{template "iAgreeDeclaration" required "WEB_Declaration_4" (school "WEB_Declaration_4")}}
{{template "iAgreeDeclaration" optional "WEB_Declaration_5" (school "WEB_Declaration_5")}}
*/}}
File Uploads
Passport
{{template "inputUpload" optional "Passport_File"}}
Your Photo
{{template "inputUpload" optional "Picture_File"}}
Last School Report
{{template "inputUpload" optional "Report_File"}}
Insurance Certificate
{{template "inputUpload" optional "Insurance_Certificate_File"}}
Signed Declaration (see above)
{{template "inputUpload" required "Declaration_File"}}

{{define "iAgreeDeclaration"}}
{{html (paragraph (index .Params 0))}}
{{end}} {{define "declaration"}}
{{if .Required}}{{template "required"}}{{end}}
{{end}} {{define "hidden"}}}{{end}} {{define "inputText"}}{{if .Required}}{{template "required"}}{{end}}{{end}} {{define "inputTextSize"}}{{end}} {{define "inputTextPlaceholder"}}{{if .Required}}{{template "required"}}{{end}}{{end}} {{define "inputDate"}} {{$d := .DateStringParts}} {{template "dateSelect" group .Name "1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31" $d.Day .Validate}} {{template "dateSelect" group .Name "Jan,Feb,Mar,Apr,May,Jun,Jul,Aug,Sep,Oct,Nov,Dec" $d.Month .Validate}} {{template "dateSelect" group .Name (index .Params 0) $d.Year .Validate}} {{if .Required}}{{template "required"}}{{end}} {{end}} {{define "dateSelect"}} {{end}} {{define "inputLineSelect"}}{{if .Required}}{{template "required"}}{{end}}{{end}} {{define "inputSelect"}}{{if .Required}}{{template "required"}}{{end}}{{end}} {{define "inputRadios"}}
{{$name := .Name}}{{$value := .Value}}{{range $i,$v := split (index .Params 0) ","}} {{end}} {{if .Required}}{{template "required"}}{{end}}
{{end}} {{define "inputLineRadios"}}
{{$name := .Name}}{{$value := .Value}}{{range $i,$v := linesplit (index .Params 0)}} {{end}} {{if .Required}}{{template "required"}}{{end}}
{{end}} {{define "inputChecks"}}
{{$name := .Name}}{{$value := .Value}}{{range $i,$v := split (index .Params 0) ","}} {{end}} {{if .Required}}{{template "required"}}{{end}}
{{end}} {{define "inputLineChecks"}}
{{$name := .Name}}{{$value := .Value}}{{range $i,$v := linesplit (index .Params 0)}} {{end}} {{if .Required}}{{template "required"}}{{end}}
{{end}} {{define "inputUpload"}} {{if .Required}}{{template "required"}}{{end}} {{if .Size}}{{.Value}} - {{.Type}} {{.Size}}{{end}} {{end}} {{define "inputArea"}}{{if .Required}}{{template "required"}}{{end}}{{end}} {{define "inputAreaLarge"}}{{if .Required}}{{template "required"}}{{end}}{{end}} {{define "inputIntPhone"}} {{$parts := linesplit .Value}} +--{{if .Required}}{{template "required"}}{{end}} {{end}} {{define "required"}} *{{end}}

{{/* Declaration Example - See https://golang.org/pkg/text/template/ for syntax. Template params are automatically escaped. */}} {{school "Name"}} Declaration Form

{{school "Name"}} Declaration Form

Student Declaration

{{html (paragraph (school "WEB_Declaration_1") "

")}}

{{html (paragraph (school "WEB_Declaration_2") "

")}}

Name:
Signature:
Date:

Parent/Caregiver Declaration

{{html (paragraph (school "WEB_Declaration_3") "

")}}

{{html (paragraph (school "WEB_Declaration_4") "

")}}

Optional: {{html (paragraph (school "WEB_Declaration_5") "

")}}

Name:
Signature:
Date: