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Section 1 - Personal Information
First name	Family name
Preferred Name	Male Female	Nationality
Date of Birth	Native Language

Home Address
City/Town	Country	Postal Code
Phone No.	Fax No.	Occupation
Email		First Language
Other Language

NZ Address
Phone No.		Email
Fax No.		Contact Person for emergency?

How did you hear about Sheffield School?	Agency Recommendation Advertisement
How did you book this course?	Name of Agent		Direct Contact (Walk-in)	yes

Section 2 - Course Information
Start Date		No. of Weeks		End Date

Please indicate your English level 0=no english / 6-advanced
0 1 2 3 4 5 6
How long have you been studying English?	year(s)

Please check the course you wish to enrol.
General English Courses	Examination Courses	School Preparation	Study & Activity
Beginner	IELTS	High School	Skin Scuba
Elementary	Cambridge PET	University	Wind Surfing
Pre-Intermediate
Intermediate	Cambridge FCE		Yachting
Upper-Intermediate
Advanced	Cambridge CAE		Golf
Special courses	Study & Work Course	Study & experience Course
Part time	Full time

Section 3 - Accommodation Details

Arrival date
/Flight No.

Accommodation Start Date

End Date

Homestay Flatting/Lodging Apartment

Room

Single Twin

Do you Smoke?

yes No

Special request e.g. vegetarian, allergies, dietary, etc

yes

Please Check the course you wish to enrol
General English Courses		Examination Courses
Beginner/Elementary		IELTS-Gen.
Pre-Intermediate		IELTS-Univ.
Intermediate		Essay Special
Upper-Intermediate		Essay Special
Upper Intermediate/Advanced
Part time		Full time

When you have completed the enrolment form, carefully check all details. Make sure that you have answered all the questions correctly and that you have signed at the bottom of this page.
Send this form to the school by fax or mail.
When we receive the form, we will send you a confirmation for the programme you have booked along with the corresponding invoice.

I have read, understand and accept the conditions of tution and/or homestay printed on this enrolment form.

Signature of applicant

Date

Signature of parent/guardian

Date

Please note that we cannot accept your booking without your signature and that of your parent.guardian if you are under 18 at the time of making this booking.

入学お申し込み方法

1. 入学申込書に必要事項をご記入の上、下記の住所までご郵送あるいはFAXして下さい。当ホームページからオン・ラインで、お申し込みも可能です。

2. お申込書を受理次第、当校から入学許可書と請求書をご送付させて頂きます。

3. 請求書がお手元に届きましたら、費用のお支払いお願い致します。お支払いは、日本からの場合は、銀行からの海外送金（当校銀行口座詳細は、請求書に記載）となり、ニュージーランド国内からお申し込みの場合は、各銀行からのご入金、銀行小切手、当校受付けにて現金あるいはクレジットカードでのお支払いも可能でございます。ご入金の確認が出来次第、当校より領収書を発行させて頂きます。

尚、学生ビザ申請に関しましては、学校からの入学許可書と領収書が必要となります。ホームステイをお申し込みの場合には、ホームステイ保証書及びホストファミリーの詳細もお送り致します

何かご質問等がございましたら、お気軽に日本人スタッフまで、お問い合わせ下さいませ。

Sheffield English Language School
PO Box 106417, Downtown, Auckland, New Zealand
Phone: +64 9 309 0052
Fax: +64 9 309 6002
Email : info@sheffieldshool.net （日本語対応）

Cessation of enrolment

The Director of Studies will withdraw a student's enrolment from the course if the student is absent without contact for at least two consecutive weeks and will notify the appropriate authorities.

Refunds

Refunds, which are issued by the authorized independent trustee of the school, will be returned to the person who sent the money to Sheffield English Language School unless agreed otherwise. All discussions concerning conditions of enrolment and cancellation are subject to New Zealand Law.

Cancellation made in writing at least 14 days before course commencement will result in full refund of fees.

No refund is normally made in the case of withdrawal more than 7 days after the course commencement date.
If a student withdraws within seven days of course commencement he or she is entitled to a refund of any fees, including registration fee and agents fees, paid less 10% or $500.00, whichever is the lesser amount paid in NZ dollars at the current exchange rate.