Leisure Learn Application Form

 

Please fill out all sections of the application

PERSONAL DETAILS
Family Name
Given Name
Date of Birth dd/mm/yyyy
Gender Male Female
Home Country Address
Telephone - Day (Home)
Telephone - Night (Home)
Your Email
Fax
Emergency Contact Name
Emergency Contact Number

PASSPORT DETAILS
Nationality
Number
Expiry Date dd/mm/yyyy

ACADEMIC DETAILS
Level of English for speaking
Very little Quite good Very good
 Don't know
Level of English for listening
Very little Quite good Very good
 Don't know
Level of English for reading
Very little Quite good Very good
 Don't know
Level of English for writing
Very little Quite good Very good Don't know

COURSE YOU ARE APPLYING FOR


General English Intensive
Start Date No of Weeks Finish Date Cost
General English (part time)
Cost
High School Preparation 12 weeks
Start Date No of Weeks Finish Date Cost
Farmstay
Start Date No of Weeks Finish Date Cost
General English + Activities
Start Date No of Weeks Finish Date Cost
Cambridge Exam Preparation
PET
No of Weeks Cost
FOE
No of Weeks Finish Date Cost
CAE
No of Weeks Finish Date Cost
CPE
No of Weeks Finish Date Cost
IELTS/TOEFL
No of Weeks Finish Date Cost
Dairy Internship
No of Weeks Finish Date Cost
STUDENT FEES
COURSE RELATED COSTS		 All prices are quoted in $NZ and are inclusive of GST Total
Course Registration    Once only $150
Material Fee            All Courses $12 per week
Farnstay Placement Fee   
COURSE COSTS
Intensive General English Full time 1-12 weeks @ $350 per week
13-24 weeks @ $315 per week
25+ weeks @ $295 per week
Intensive General English Part time $210 per week
High School Preparation 6 weeks @ $2100
Private Tuition TOEIC IELTS General $60 per 1.5 hours
Cambridge Exam Preparation. 12 weeks
Dairy Internship 4 weeks
Are you interested in
Conversation classes
Private tuition
Tours
Secondary School Holiday Groups
ACCOMMODATION COSTS
Placement (homestay, backpackers, motel etc)
Once only and payable only if LLE is requested to place you		 $175
Placement students 18 years and under & 3 months stay or more $400 transfers included
Homestay weekly
includes 2 meals per day weekdays and 3 meals per day on weekends
$230-250 per week
All other accommodation types - see Accommodation
No booking fee required for Southern Cross Lodge
Return Transfer if required $180
Homestay Preferences
With young children ? Yes No
With teenage children ? Yes No
With no children ? Yes No
Don't Mind ? Yes No
Pets ? Yes No
Smoking ? Yes No
Town or Farm ? Town Farm
Don't mind ? Yes No
Do you want us to meet you at the airport ? Yes No
Do you want us to arrange your departure transfer ? Yes No
INSURANCE
Before leaving for New Zealand, you must have travel and medical insurance
I will make my own arrangements
Please send me information about LLE's preferred policy
Please read the Insurance and Camstaff requirements by clicking the tabs above.