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| First Name * |
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| Family Name * |
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| Mailing Address |
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| Apartment/Suite Number |
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| City |
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| State/Province |
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| Zip or Postal Code |
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| Country |
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| Phone (include country code) |
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| Fax (include country code) |
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| E-mail Address * |
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| Date of Birth * |
(mm/dd/yyyy)
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| Your Gender * |
Male
Female
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| Passports held for which countries? * |
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| Name and Phone of Emergency Contact * |
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| Your Education * |
No college
Some college
College graduate
Graduate degree
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| Focus of Studies |
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| Degree(s) Granted |
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| Name of College(s) |
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Professional Work Experience
and Dates/Length of Service |
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Previous Teaching Experience
and Dates/Length of Service |
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| Current Profession |
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| Knowledge of Other Languages |
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| Please describe any special requirements,
medical conditions or dietary restrictions |
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Accommodation
~ Choose an option
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Option 1- Tuition Only - US$1,490.00 (excluding
accommodations) |
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Option 2 - Tuition Plus Dorm - at Aspire International
Villa (excludes all meals and laundry service) US$1,690.00 |
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Option 3 - Tuition Plus Single Room - at Aspire
International Villa (excludes all meals and laundry
service) US $1,890.00 |
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Option 4 - Tuition Plus Full-service Twin-share
at Aspire International Villa with Breakfast and Dinner
Mon-Fri, 3 meals Sat-Sun, laundry Service included US$2,190.00 |
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Option 5 - Tuition Plus Full-services Single Room
at Aspire International Villa with Breakfast and Dinner
Mon-Fri, 3 meals Sat-Sun, laundry services US$2,390.00 |
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Airport
Pick-up Service
From
Auckland International Airport to Thames
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Option 1 - Return
Airport Pickup Service
Auckland or Hamilton Airport pick- up NZ$125.00 |
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Option 2 - One-way Airport Pickup Service Auckland
or Hamilton Airport pick- up NZ$65.00
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| First Choice of Location * |
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| First choice Preferred Course
Dates * (Select location first) |
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| Second Choice of Location |
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| Second choice Preferred Course Dates (Select
location first) |
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| Please briefly explain why you wish to take
a TESOL course and your employment plans after you complete
the course * |
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| How did you hear about us? |
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| Additional Comments |
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| Reconfirm Email Address * |
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