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Apply Now - Enrolment Form

Fill out and submit our online enrolment form below or print out and fax (+64 3 442 6676 ) to the Queenstown Language School .

Enrolment Form


Fill out and click send, or print-out and fax to +64 3 442-6676

* indicates a compulsory field that must be filled in

Personal Details
Given Name(s): *
Family Name(s): *
Email: *
Address: *
Town/City & State: *
Country: *
Phone Number: *
Date of Birth: *
Sex: *
Nationality: *
Job:
Passport Number: *
Emergency Contact
(name, phone number
and/or address): *
Course Information

Which school do you wish to study at?

Course required:

For other courses not listed, please state:

Preferred Start Date: *
Preferred Finish Date: *

What is your English Level?

Accomodation, Interests & Health

Do you require accommodation?

Do you smoke?

Would you like to stay with a family with pets?


Would you like to stay with a family with children?


Do you have any health problems?
Please enter the details of any health problems you may have


What are your interests?


Airport pickup required?
(free with homestay booking)
Arrival Flight details - Flight number, date, time


Other comments, questions or requirements

Declaration I have read, understand and agree to the Conditions of Enrolment.

(if student is under 18) please provide guardian details


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