INTERNATIONAL STUDENT APPLICATION FORM AND CONTRACT OF ENROLMENT

SECONDARY SCHOOL

210 Lake Road, Takapuna, Auckland 0622, New Zealand Email: international@[Link]

PART ONE: APPLICATION FORM

Note: It is important that you include all relevant information about the student in your application. This information is used to ensure that
the student is supported properly upon arrival and to match them with suitable Homestays, teachers, and courses. Where information is
included relating to health issues or learning needs, disclosure of this information will not automatically disqualify the Student from Enrolment.
However, failure to disclose information or providing misleading information may result in the withdrawal of an Offer of Place or termination
of a Contract of Enrolment.

Student Details (Name must be as it appears on your passport)

Family name:
First name: Date of birth:
Preferred name:
 Female  Male  _________
Email:
Address: (In home
country)

First language: Country of citizenship:

Passport number: Expiry date:
Intended start date: Intended end date:
Applying for year level: 9  10  11  12  13  International Baccalaureate

Parent One or Legal Guardian: (Name must be as it appears on your passport)

NOTE: It is requirement of New Zealand regulations that schools must maintain effective communication with parents and legal
guardians. To comply with the requirements, contact information provided in this section MUST be the contact information for the
parents or legal guardian.

Title: Mrs  Miss  Ms  Mr  Dr  Occupation:

Family name: Date of birth:
First name(s): Relationship to student:
Street address:
Postal address:

Home phone: Mobile: Email:

First language: Country of citizenship:
Passport number: Expiry date:

Parent Two or Legal Guardian: (Name must be as it appears on your passport)

NOTE: It is requirement of New Zealand regulations that schools must maintain effective communication with parents and legal
guardians. To comply with the requirements, contact information provided in this section MUST be the contact information for the
parents or legal guardian.

Title: Mrs  Miss  Ms  Mr  Dr  Occupation:

Family name: Date of birth:

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First name: Relationship to student:
Street address:
Postal address:
Home phone: Mobile: Email:
First language: Country of citizenship:
Passport number: Expiry date:

Emergency Contact (In home country, other than parents):

Contact's name:
Relationship to the student:
Mobile phone:
Home phone:
Email address:

Agent Information (If using an agent)

Agency name:
Agent name:
Agent email address: Phone:

Medical Information
Name of doctor (in home country):
Phone number of doctor:
Does the student have any history of previous physical or mental health illness or problems that may affect their enrolment?
 Yes  No
If ‘Yes’, please provide details including doctor or hospital reports (attach more pages if required).

Has the student been fully vaccinated for Covid-19?  Yes  No

If ‘Yes’, please provide: Name of the vaccine: Number of doses:

Please attached evidence of vaccination to this application.
Has the student been vaccinated for diseases other than Covid-19?  Yes  No

 Yes  No
If ‘Yes’, please provide a copy of the vaccination certificate/s.

Please tick the appropriate box if you suffer from or have suffered from any of the following medical conditions:
□ Asthma □ Back/Neck problems □ Glandular Fever □ Allergy to bee/wasp stings □ Migraines
□ HIV or Aids □ Diabetes □ Hepatitis A, B or C □ Epilepsy □ Heart Condition
□ Tuberculosis □ ADD or ADHD □ Allergies □ Food Allergies □ Eating Disorder
□ Depression/Anxiety □ Autism Spectrum Disorder □ Asperger’s Syndrome □ Covid-19 □ Other: (Please describe)

Does the student have any medical implants (such as metal implants) that may affect receiving medical treatment while in New Zealand?

 Yes  No
If ‘Yes’, please provide details (attach more pages if required).

Is the student currently on any medication?

 Yes  No
If ‘Yes’, please provide details (attach more pages if required).

Please note: If you suffer from conditions requiring medication, it is advisable to bring your own medication to NZ. You will be required to notify the school
regarding any medications that you bring with you.

Does the student smoke?  Yes  No

Is there anything further regarding the health of the student that the school needs to be aware of in enrolling and supporting the student as an
international student?

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 Yes  No
If ‘Yes’, please provide details (attach more pages if required).

Do you agree to the school providing over-the-counter medication *such as acetaminophen, paracetamol, or ibuprofen?

 Yes  No
If ‘No’ please specify what medications you do NOT want the student to receive:

Learning Information
Current school: Grade/year level:
If the student does not currently attend school, please give reasons and date of last attendance:

Please describe your learning goals for studying in a New Zealand school (attach more pages if required).

How many years of schooling not including pre-school education has the student had?

During this time, has the student not attended school for 1 month or longer?  Yes  No
If ‘Yes’, please give details (dates and reason):

Please provide a copy of the lastest two school reports for the student with this application
Does the student have any learning or behavioural difficulties which may require extra school support or services?

 Yes  No
If ‘Yes’, please provide details including any psychologist assessments and reports that are available (attach more pages if required).

General Details
Has the student previously applied for entry to the school?
 Yes  No
If yes, when?
Has the student ever had a family member or relative enrolled at the school? Yes No
Name: Year attended:
Has the student previously studied at any other NZ school?
 Yes  No

If ‘Yes’, please state the name of the school: Dates:

For how many years has the student studied English? [ ] Months [ ] Years

Do the student’s parents speak or read English? Speak  Yes  No Read  Yes  No
Has the student been convicted or been the subject of any matter before any Court?

 Yes  No
If ‘Yes’, please provide details (attach more pages if required).

Please attach a hand-written letter from the student introducing themselves and explaining their reasons for wanting to study at this school.

Accommodation Requirements

Accommodation choice:  Homestay  Designated caregiver (relative or family friend)  Live with parent

Interests:  Music  Movies/TV  Reading  Outdoor Activities  Sports  Travel

Other interests:

Does the student have any food allergies or special dietary requirements?

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  Yes  No
If ‘Yes’, please provide details (attach extra pages if required).

Does the student have any other special requirements for accommodation? (Pets, cultural or religious requirements, phobias)
 Yes  No
If ‘Yes’, please provide details (attach more pages if required).

Please write a brief letter introducing yourself to your host family and attach it to this application

Designated Caregiver Details (If staying with a relative or close family friend)
Name of caregiver:
Address (in NZ):

Home phone: Mobile:

Email:
Relationship to student:

Insurance Details

Do you wish to purchase insurance through the school?  Yes  No

If you are providing your own insurance, please provide an English copy of the policy details to the school once purchased.
If you wish to purchase your insurance through the school, please ensure the medical information section on this form is completed fully and
accurately to ensure appropriate coverage for the student for any pre-existing conditions they may have.

Please note: Subject choices in this application are an indication only and actual subjects will depend upon availability and prior learning. The
school reserves the right to decide subject placement and year level throughout enrolment in consultation with students and families.

Subject Choices
Subject Year Level Subject Year Level
1. 4.
2. 5.
3. 6.

Checklist of documents and Information you must include with your application
Photograph of the student Passport size photograph

A copy of the student’s last two school reports

A hand-written letter from the student introducing themselves, and explaining their
reasons for wanting to study at the school
A copy of the student’s passport including passport number and expiry date
A copy of the student’s insurance policy details, if booking their own, with English
translation (this may be submitted after enrolment is confirmed but must be prior to
departure from the home country
A copy of the student’s vaccination certificate

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Initialled by: __________________(parent) ____________________(student)

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PART TWO:

THE TERMS AND CONDITIONS ATTACHED TO THIS APPLICATION, FORM AND GOVERN THE STUDENT’S TUITION AT THE SCHOOL. BY SIGNING
BELOW, THE STUDENT, THE SCHOOL AND THE PARENTS OR LEGAL GUARDIAN AGREE TO THOSE TERMS AND CONDITIONS. PLEASE ENSURE
YOU READ THE TERMS AND CONDITIONS CAREFULLY.

Terms and Conditions:

Tuition means the education of the Student at the School or, in
Definitions appropriate circumstances, education provided to the Student by
the School through online, remote or distance learning.
1. For the purposes of this Agreement the following terms shall have the
following meanings: Period of Enrolment means any period for which Fees are paid and
for the purpose of this Agreement the enrolment of the Student
Accommodation means the residential accommodation provided to begins on the course start date stated in the Student’s Offer of Place
the Student. and ends on the course end date stated in the Student’s Offer of
Place, or on such earlier date as the parties agree or the School
Accommodation Agreement means the agreement between the terminates the Agreement according to clause 28 or 30 of the
Student, the School, and the Parents, which governs the Student’s Agreement.
accommodation arrangements.
Welfare Issue means any situation where the School holds a
Act means the Education and Training Act 2020. concern about the Student’s safety or wellbeing, or where the
School considers it cannot meet its obligations under the Code
Agreement means this Agreement including these terms and and/or the Act with respect to the Student’s health and safety for
conditions and any schedules. any reason.

Application Form means the standard enrolment form which forms Preliminary Provisions
the cover page of this Agreement.
2. The Agreement is declared to be a contract of enrolment in terms of
Code means the Education (Pastoral Care of Tertiary and section 10 of the Act.
International Learners) Code of Practice 2021.
3. The School shall provide Tuition to the Student in line with school
Designated Caregiver has the meaning as set out in the Code. policies, the Code, the Act and any other applicable laws, in return for
the payment of the Fee.
Disciplinary Action includes termination of this Agreement and
suspension, expulsion and exclusion of the Student as those terms Terms of Agreement
are defined in the Act.
4. Unless otherwise agreed in writing between the parties, the School's
Fee means fees payable by the Parents to the School as per the Fee responsibility for the Student starts on the first day of the Period of
Schedule. Enrolment and ends on the last day of the Period of Enrolment, or in
the event that the Student’s Tuition is terminated, on the date of
Fee Schedule means the schedule of fees for Tuition, termination. The parties agree that any period of time in which the
Accommodation and other charges, which is available from the Student is in New Zealand before or after the Period of Enrolment will
School on request and may be updated from time to time. be at the risk of the Student and Parents and that the School will have
no legal or moral responsibility for what occurs during this period
Homestay has the meaning as set out in the Code. unless otherwise agreed in writing.

Legal Guardian means the person or persons who is legally the 5. Except in the circumstances described in clauses 6, 7 and 8, the
guardian of the Student in their home country and has the legal conditions in this Agreement apply for the whole time the Student is
right to make decisions about their care, education and well-being. enrolled at the School during a Period of Enrolment. The Agreement
It can include parents, where they have the right to make decisions may be renewed on application to the School in writing. Renewal of
for the Student. this Agreement is at the sole and absolute discretion of the School
and is subject to satisfactory performance and attendance by the
Offer of Place means a Confirmed Offer of Place and does not Student, the School making an Offer of Place for a further Period of
include any provisional offer. Enrolment and the payment of Fees. For avoidance of doubt, should
this Agreement be renewed the Period of Enrolment for the renewed
Parent means the student’s biological or legally adoptive parent. term shall be that stated in the Offer of Place issued by the School to
Except where the context requires otherwise, references to Parents the Student for the renewed term.
in this agreement includes Legal Guardians and also includes a single
Parent who has the sole right of guardianship in relation to the
6. The School is not responsible for the Student if the Student chooses
child.
to leave New Zealand during the Period of Enrolment. Should the
Student leave New Zealand during the Period of Enrolment other
Residential Caregiver has the meaning as set out in the Code.
than as part of a School organised trip the School’s responsibility for
the Student shall end upon the Student’s departure and resume upon
School means the school referred to in the annexed Application
the Student returning to New Zealand.
Form.

Student means the student referred to in the annexed Application 7. This Agreement is considered to be written agreement from the
Form. Parent that the School is not responsible for the Student’s day-to-day
care where the student is in the custody of a Residential Caregiver
Termination means termination of the Agreement and includes who is a supervisor for the Student while the Student is in temporary
termination by the School expelling or excluding the Student. accommodation and that supervisor is not a resident of New Zealand

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 and is travelling with or accompanying the Student for the purpose
of supervising them during the Period of Enrolment. 18. The Fee must be paid to the School in advance of each Period of
Enrolment or as otherwise directed by the School. The Parents and
8. The School is not responsible for the Student’s day-to-day care where the Student agree to comply with School policies regarding the
the Student is in the custody of a person approved by the Parent as payment of the Fee.
part of a transfer-of-care arrangement during enrolment made in
accordance with the Code. 19. If Tuition is terminated by the School during a Period of Enrolment,
any refund of the Fee applicable to that Period of Enrolment will be
assessed according to the refund policy which is annexed to this
9. During the Period of Enrolment the Student must keep the School Agreement as Schedule Three, as updated by the School from time to
reasonably informed of their whereabouts including if the Student time.
intends to leave New Zealand during the Period of Enrolment.
Information, Warranties and Acknowledgements
Accommodation
20. The Parents agree to provide the School with educational, medical,
10. The Parents and Student agree that no changes to accommodation financial, or other information relating to the wellbeing of the
arrangements will be made without the prior written agreement of Student as may be requested from time to time by the School. If the
the School. Parents provide misleading information or fail to disclose information
about the Student to the School, such that the School has to change
11. The Parents and the Student agree that this Agreement is subject to or modify the level of Tuition or Accommodation required by the
and conditional on the School being satisfied that the Student has Student, the School may charge the Parents such fees as required to
appropriate accommodation arrangements in place and, where adequately compensate for such extra requirements. For avoidance
applicable, an Accommodation Agreement or Designated Caregiver of doubt, the obligation to disclose information continues during the
Agreement being entered into by all relevant parties. term of this Agreement and the Parents must notify the School of any
changing conditions in relation to the Student.
12. The Parents irrevocably authorise the principal of the School to
21. The Student and the Parents confirm that:
inform the Residential Caregiver (whether or not arranged through
the School) of all matters and information required to be provided to
(a) The Student does not suffer from any medical condition or
the Parents and agree to appoint the Residential Caregiver in New
behavioural condition (including mental health conditions
Zealand to receive such information in place of the Parents.
and allergies) that may negatively impact on the health,
safety or education of the Student or any other student at
Immigration and Insurance
the School, except as disclosed on the Application Form;
13. The Parents and Student agree to comply with the visa requirements
as set out in the Immigration Act 2009, and any visa conditions (b) The Student does not have any medical or other special
applicable to the Student’s stay in New Zealand. The Parents and needs that require extra support, except as disclosed in
Student understand that the School has an obligation to report any the Application Form;
breaches of the visa requirements to the appropriate immigration
authority. (c) The Student has never been charged with or convicted of
any crime, and is not the subject of other proceedings
before any court, except as disclosed in writing on the
14. The Student must maintain an up-to-date visa as stipulated by
Application Form;
Immigration New Zealand.

15. The Parents agree that it is a condition of enrolment that the Student (d) All information in the Application Form is true and correct
has current and comprehensive travel and medical insurance. Where to the best of their knowledge and belief.
insurance in not arranged by the School, the Parents will provide the
School with evidence of the relevant insurance policy. If appropriate 22. The Parents and Student acknowledge that:
evidence is not provided, the School may organise insurance it
considers appropriate and pass on this cost to the Student or Parents. (a) The School may obtain at any time from any person or
organisation any information it requires to process and/or
16. The Parents agree they have read the policy details for the Student’s accept the Student for admission to the School or to
travel insurance policy and any other relevant information provided perform or complete any of the other purposes under this
by the insurer from time to time and: Agreement. The Parents and the Student authorise any
(a) accepts all exclusions that apply to the insurance policy such person to release to the School any personal
and information that person holds concerning the Student
(b) agrees that where the school arranges insurance on behalf and/or Parents.
of the Parents, the Parents have disclosed all medical
conditions to the School that may affect insurance cover. (b) If the Student and/or Parents fail to provide any
information requested in relation the Student’s admission
to the School, the School may be unable to process the
17. The Parents agree to cover any costs for the Student that are
Student’s application.
excluded by the Student’s travel insurance policy and are not
otherwise covered by publicly funded medical services in New
(c) This Agreement is conditional at all times on the Student
Zealand. For the avoidance of doubt, the Parents agree that the
having accommodation in New Zealand which complies
School is not responsible for any costs incurred on behalf of the
with the Code. If this condition is unable to remain
Student that are excluded by the Student’s travel insurance policy or
fulfilled, then this Agreement will be at an end.
not covered by publicly funded medical services in New Zealand.
(d) Personal information of the Student and/or Parents
collected or held by the School is provided and may be
held, used and disclosed to enable the School to process
Fees
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 the Student’s eligibility to receive Tuition at the School physical activities, regardless of whether agreement is sought from
and Accommodation. domestic students in relation to the same activity.

(e) The Parents agree that where the Student lives in a 26. Unless otherwise agreed in writing by the parties, this Agreement is
School approved Homestay, this Agreement is considered to be written agreement for leisure travel or stays
subject to an Accommodation Agreement being organised and supervised by the Student’s Residential Caregiver
entered into by the School and the Parents. Where where the travel is within New Zealand for a period of not more than
the Student lives with a Designated Caregiver, this seven days and does not result in the Student missing any scheduled
Agreement is subject to a Designated Caregiver school days.
Agreement being entered into by the School, the
Parents and the Designated Caregiver. In either case, Conduct, Welfare, Discipline and Termination
a breach by the Student of the Accommodation
Agreement or of the Designated Caregiver 27. The Student will comply at all times with School policies, the Code
Agreement will be considered to be a breach of this and the Act, and the Parents shall work with the School to ensure
Agreement. such compliance. This includes compliance with the School Code of
Conduct in Schedule One, including any amendments made by the
(f) All personal information provided to the School is School during the Period of Enrolment.
collected and will be held by the School.
28. In the event of any breach of this Agreement by the Student or the
(g) The Student and Parents have the right under the Parents, the School may take any Disciplinary Action it considers
Privacy Act 2020 to obtain access to and request appropriate, including terminating this Agreement, and/or
corrections of any personal information held by the suspending, excluding or expelling the Student and (if applicable)
School concerning them. notifying Immigration New Zealand of its decision to terminate the
Agreement or to exclude or expel the Student.
(h) Under the Privacy Act 2020, any information
collected may be provided to education authorities. 29. Without limitations, the following actions shall be considered to be
breaches of this Agreement which may warrant Disciplinary Action:
(i) Information relating to the education, health, welfare
or safety of the Student, may be released to relevant (a) Refusal by the Student to obey any reasonable
people outside the School, at the discretion of the instruction given by any employee or officer of the
School. School during the Period of Enrolment;

(j) Where necessary to carry out any process under this (b) Any breach of the School Code of Conduct by the
Agreement, or to make any decision concerning the Student;
Student, the School may disclose personal
information to any person, including immigration
authorities, airlines, and travel agents. (c) Any breach of the Accommodation Agreement or
Designated Caregiver Agreement by the Student or
(k) Photographs and videos of the Student may be used Parent;
for the Student’s records and in any publicity material
for the School, including social media posts by school (d) Any act by the Student during the Period of
staff, unless otherwise agreed in writing by the Enrolment that creates a risk to the safety of any
parties. person;

Consent
(e) Any act by the Student during the Period of
Enrolment that threatens the education of any other
23. The Parents and the Student, who have signed this Agreement
Student;
appoint and authorise the principal of the School (or such other
person as may be appointed by the School to carry out the principal’s
duties) to: (f) Any breach of clauses 14 or 15 of this Agreement or
of the warranties contained in clause 21 of this
(a) Receive information from any person, authority, or Agreement;
corporate body concerning the Student including, but
not limited to, medical, financial, educational or (g) Failure to make payments invoiced according to the
welfare information; Fee Schedule; and

(b) Provide agreements on the Student's behalf in the

event of a medical emergency where it is not (h) Any other breach of this Agreement
reasonably possible to contact the Parents.
30. Where appropriate, the School will follow the process set out in the
24. The School shall seek specific written agreement of the Parents Investigation Policy which is annexed to this Agreement as Schedule
before the Student, being a student of any age, participates in any Two when exercising its disciplinary powers as stated in clause 28 of
activity either organised by the School or by another party which is this Agreement, but nothing in this Agreement shall limit the power
considered to be an adventure activity or extreme sport or an activity of the School to immediately terminate this Agreement or expel or
that is organised by the School and requires the Student to stay away exclude the Student for serious misconduct or to suspend the Student
from their regular accommodation overnight. pending investigation if the School concludes that this step is
necessary for the purpose of protecting the safety of any person,
25. Except in the circumstances described in clause 24, this Agreement is including the Student.
considered to be written agreement of the Parents for any activity
organised and/or supervised by the School, including trips and 31. The School may terminate this Agreement if there is a Welfare Issue
and the School forms the view that it cannot reasonably continue to
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 meet its obligations under the Code or the Act with respect to the
health and wellbeing of the Student within the School.

32. Where appropriate, the School will follow the process set out in the
Investigation Policy which is annexed to this Agreement as Schedule
Two when exercising the power in clause 31 of this Agreement, but
nothing in this Agreement shall limit the power of the School to take
urgent action, including terminating this Agreement or sending the
Student home, where it considers that it is necessary to do so.

General Matters

33. No party to this Agreement is liable to the other for failing to meet its
obligations under this Agreement to the extent that the failure was
caused by an act of God or other circumstances beyond its reasonable
control.

34. This Agreement shall be construed and take effect according to the
non-exclusive laws of New Zealand. In relation to any legal action or
proceedings arising out of or in connection with this Agreement the
Parents:

(a) Submit to the non-exclusive jurisdiction of the Courts

of New Zealand; and

(b) Agree that proceedings may be brought before any

Court including any forum constituted under the
Arbitration Act 1996 within New Zealand and waive
any objection to proceedings in any such Court or
forum on the grounds of venue or on the grounds that
the proceedings have been brought in an
inconvenient forum.

35. Notices given under this Agreement must be in writing and given to
the addresses set out in the Application Form. Those notices sent by
post will be considered to have been received ten (10) days after
posting.

36. Notices may also be given by sending an email to the email addresses
specified on the first page of this Agreement and will be considered
to have been received twelve (12) hours after it has been sent.

37. This Agreement contains the entire understanding between the

parties. The terms of the Agreement may only be changed by
the School in consultation with the Student, and Parents, except
where such change is required by New Zealand legislation or the
Code. This Agreement shall continue in force during the Period of
Enrolment with the School.

38. The School shall at all times comply with the Health and Safety at
Work Act 2015.

39. Nothing in this Agreement limits any rights that the Parents or
Student may have under the Consumer Guarantees Act 1993.

40. The parties acknowledge that prior to signing this Agreement, they
have had the opportunity to seek independent legal advice about its
content and effect.

41. This Agreement may be signed in one or more counterparts, each of

which when so signed and all of which together shall constitute one
and the same Agreement. Delivery of signed counterparts may be
delivered by email, facsimile transmission or through an internet
service set up for that purpose.

42. The parties agree that any dispute in relation to this Agreement will
be resolved in line with the Code and the School Policies.

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PARENTS’ AND STUDENTS’ DECLARATION AND AUTHORISATION

We declare that the information contained in this application is true and complete. We understand that any false or incomplete
information submitted in support of this application may invalidate this application and may result in the withdrawal of an Offer of Place.
We agree that we have received sufficient information to make an informed decision about enrolment at the School.

Key Terms: This Agreement includes provisions:

(i) that allow the School to discipline the Student, including by expulsion, or to remove them from the School on
health and welfare grounds;
(ii) that control and limit the Student’s rights of refund when Enrolment ends early;
(iii) that require the Parents to make full disclosure of all relevant information; and
(iv) that provide agreement for the School to permit certain activities without further agreement from the Parents.

This is an important legal document, please read all clauses carefully.

By signing this Agreement, you confirm that all of the information in the Application Form is true and complete.

SIGNING

Parents

By signing below, the Parents (as applicable) confirm that they have read the Agreement and agree to be bound by it in all respects: (please
also initial each page of the Agreement, including the schedules)

Name(s): ___________________________________

___________________________________

Signature(s): ___________________________________

___________________________________

Date: ___________________________________

School

By signing below, the authorised signatory of the School confirms that they are authorised to sign on behalf of the School, and confirms
that the School will be bound by the Agreement in all respects:

Name: ___________________________________

Signature: ___________________________________

Date: ___________________________________

Student

By signing below, the Student confirms they have read and understood the Agreement and agrees to abide by the Code, School Policies
and (to the extent applicable) the Agreement: (please also initial each page of the Agreement, including the schedules)

Name: ___________________________________

Signature: ___________________________________

Date: ___________________________________

Initialled by: __________________(parent) ____________________(student) 9

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 Code of Conduct
(Schedule One)

Students at Takapuna Grammar School are expected to practice the school motto of Aspiring to Personal Excellence at all times

International Students must not violate the laws of New Zealand

Takapuna Grammar School Rules and Expectations

Attendance
Students are expected to be on time and attend all classes they are timetabled for. Students must remain within the school grounds for the duration of the
day (8.35am – 3.05pm or Wednesday 9.30am – 3.05pm Students cannot take holidays during term time
Year 13 Students Only
Can leave school at the start of lunchtime to work from home if they have a study period timetabled for Period 5.
Can purchase food from the Tuckshop during their study periods. However, this must not be during the first 10 minutes of the lesson or during the last 30
minutes of period 4.

Classroom Expectations
● Students must be on me and in class for the dura on of their lesson.
● Students should aim to use interval and lunch for bathroom breaks.
● Students can only see the school nurse during a lesson if they have a written note from their teacher.
● Should students need to leave the classroom during the lesson they must return immediately when finished.
● Students must bring the correct equipment to each class and ensure the appropriate uniform is worn e.g. closed toe shoes in Science. Devices should be
charged and able to last a full school day.

Sexual Harassment, Assault, and Bullying

● Students must not commit incidents of verbal, sexual, physical, digital or any other form of bullying or harassment. Including the use of foul, racist or sexist
language.

Harmful Substances
● Students must not be in possession of, supply, consume, or be under the influence of alcohol, illegal drugs, mind-altering substances, legal highs, solvents,
and other harmful substances.
● Takapuna Grammar School is a smokefree school. Smoking, including vaping and e-cigarettes, is not allowed anywhere on the school grounds at any time.
School activities away from school, such as EOTC or sports trips, are also smokefree.
● Teachers can request the surrender of items that they have reasonable grounds to believe may be harmful, dangerous or detrimentally affect the learning
environment.

Uniform
● The TGS uniform must be worn correctly, appropriately and with pride.

Phones and Electronic Devices

● Students may bring their phones to school but they must be turned off and in their bag between 8.40am and 3.05pm.
● Students may check their phone in the last five minutes of interval (11.20-11.25) or
lunch (2.05 - 2.10) for reasonable purposes only e.g. to check for a message from home, to view their calendar or timetable.
● Students are expected to bring a charged, working device (not a phone) to all lessons.
● Students must abide by the appropriate use of ICT policy as set out and agreed to by all students during their enrolment.

Interval and Lunchtime

● Students are to remain on school grounds during interval and lunch me. The grass strip along the seaward side of our school, and George Gair
lookout/carpark are all out of bounds.
● Food can be purchased from our TuckStop. Students must follow the guidelines for ordering their food. This includes lining
up in the appropriate spaces and respecting others around you.
● During wet weather students may use the central spaces in Rowan Nicks and the Sir Peter Blake blocks. Students may also use the corridors in the Main
building or Te Poho.
● Students may not be in classrooms during morning tea and lunch me unless they have explicit permission from the classroom teacher.
● Students must not behave in a manner that might endanger the safety of themselves, other students or staff.

Travelling To and From School

● Be respec ul and follow all road rules when travelling to school.
● Bikes and scooters must be left in the bike racks located on school grounds.
● Motorised scooters may park on school grounds in a designated area.
● Students must not behave in a manner that might endanger the safety of themselves, other students, staff or members of our local community.

Leave Passes
● Early leave passes will not be provided to students for the purpose of leaving for work, to catch an early bus or ferry, sports, dance or any co-curricular
activity.
● Parents/Caregivers must contact the Deans if a one off leave pass is required e.g. to attend a medical appointment.
● If unwell, students must visit the school nurse who can issue a leave pass and contact Parents/Caregivers.

General Expectations
● Graffi on any school or student property will not be tolerated.
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● Groups of students are not to be in the bathroom together at any me of the day. Only pone student is permitted in a toilet cubicle at the one time.

Safety
Obey the road crossing rules and observe safe traffic behaviour at all times
It is compulsory by NZ law to wear a cycle helmet while cycling
Do not bring any of the following items to school: chewing gum, cigarettes, matches, lighters, firecrackers of any type, alcohol, illegal drugs, knives, weapons
of any kind, laser light equipment of any kind

Travel
Students are not allowed to travel out of Auckland unsupervised. International Students must obtain permission from the International Faculty to be away
from their homestay.

Homestay
International student must always let their host family know where they are and obey the following curfews:

Age Sunday – Thursday Friday & Saturday

Under 15 years 6.00pm 8.30pm
15 years 6.00pm 11.00pm
16 years 6.00pm 12 midnight
17 years & over 6.00pm 1.00am

Communication
Takapuna Grammar School will contact parents with any concerns regarding students, e.g. when it is investigating concerns about the health and mental
wellbeing of a student. Where the enrolment agreement contract may be terminated early and with near immediate effect, a plan of transfer care back to
the students’ parents will be promulgated. This is to include telephone and email communication at the soonest possible time. Situations where enrolment
contract may be terminated include the emergence of a medical condition (disclosed or otherwise) or any breach under the agreement regarding
disciplinary issues.

I understand that any breaches of this Code of Conduct will be subject to the school’s discipline procedures and may result in my student visa being
terminated and me being sent home.

Signed: ________________________________________________ Dated: ______________________________________________

Investigation Policy
(Schedule Two)

1. The following is the School’s current policy for dealing with Disciplinary Actions and Welfare Issues. This is not intended to restrict
the School’s general powers relating to discipline and this policy may be changed from time to time at the discretion of the School.

Overview

2. Except in serious situations where immediate termination of the Agreement is necessary, or where the breach does not warrant
any formal response other than a warning, the School will endeavour, where appropriate, to follow a two-stage investigation
process (the Investigation Process).

3. In Stage One, the School will investigate and determine the facts of the situation being considered (the Situation), and will reach a
conclusion on what happened and whether there is a Welfare Issue or an incident that requires Disciplinary Action or the
termination of the Agreement.

4. During Stage One of the Investigation Process, the Student will have an opportunity to provide a response to any subject matter
being investigated or to any allegation made concerning the Situation.

5. In Stage Two, if the School has determined some response is required, the School will consider the appropriate outcome for the
Situation, up to and including termination of the Agreement.

6. During Stage Two of the Investigation Process, the Student will have an opportunity to provide a response to the Situation and any
proposed outcome that the School is considering taking (the Proposed Action).

7. This policy does not limit the School’s power to take appropriate action urgently and without following the Investigation Process if
this is necessary having regard to the seriousness of the Situation. Such a determination may be made at any point during the
Investigation Process.

8. This policy also does not limit the School’s power to suspend the student for the duration of the Investigation Process where
suspension is considered necessary for the safety or education of any person.
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General Policy

9. When the School is conducting an investigation involving the Student it will endeavour to provide the Student with the following:

(a) a written summary of the Situation (as it understands it) or the Proposed Action;

(b) an opportunity to respond to the Situation or the Proposed Action, either in person or in writing or both, at the choice of
the Student;

(c) an opportunity to consider the Situation or the Proposed Action for a reasonable period of time (having regard to the
seriousness of the Situation or the Proposed Action) before giving a response;

(d) an opportunity to contact his or her Parent before giving a response, unless the delay caused by contacting that person
is unreasonable having regard to the seriousness of the Situation or Proposed Action;

(e) an opportunity to have an independent support person of his or her choice present at any meeting relating to the
Investigation Process;

(f) an opportunity to meet with that support person in private at any stage during the Investigation Process;

(g) an opportunity to have a translator present (or otherwise facilitate the student participating in the Investigation Process
in his or her own language) during any meeting or process if the School or the Student considers that a language barrier
means that a translator is required; and

(h) a copy of this policy setting out the rights which the Student has when engaging in the Investigation Process.

Stage One: Incident Investigation

10. When the School learns of any incident or any other thing that may be a breach of the Agreement or might otherwise warrant a
Disciplinary Action or which may constitute a Welfare Issue, the School will notify the Student of the Situation and will provide the
Student with an opportunity to give a response.

11. Where appropriate, having regard to the seriousness of the Situation, the Student will have the opportunity to respond either in
person or in writing or both, at the choice of the Student. The School will receive this response and give it genuine consideration
before making a decision about the Situation.

12. When the School makes a decision about the Situation it will advise the Student and Parent, in writing if possible, about its
conclusion as to what happened and whether it considers that it requires some kind of formal response – whether Disciplinary
Action, Termination or other intervention.

Stage Two: Outcome Discussion

13. If the School determines that a formal response is required, it will advise the Student and Parent of the possible actions that it will
consider taking in response to the Situation and will provide the Student and Parents with an opportunity to give a response.

14. Where appropriate, having regard to the seriousness of the Situation, the Student and parent will have the opportunity to respond
either in person or in writing or both, at the choice of the Student. The School will receive this response and give it genuine
consideration before making a decision about the action to be taken.

15. When the School makes a decision about the action that it will take in response to the Situation it will advise the Student and
Parents of its decision, in writing if possible. The action will not take effect, and no actions will be taken to put it into place, until
the Student and Parents have been advised of the decision.

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 Refund Policy
(Schedule Three)

Requests for a refund of international student fees

1. The School will consider all requests for a refund of international student fees. Requests should be made in writing to the School
as soon as possible after the circumstances leading to a request. All refunds will be settled under the terms of this policy unless
otherwise agreed by the School.

2. A request for a refund should provide the following information to the School:

a. The name of the Student;

b. The circumstances of the request;
c. The amount of refund requested;
d. The name of the person requesting the refund;
e. The name of the person who paid the fees;
f. The bank account details to receive any eligible refund including bank address and swift code where relevant; and
g. Any relevant supporting documentation such as receipts or invoice.

Non-Refundable Fees

3. The School is unable to refund some fees. The following fees relate to expenses that the School may have paid or will incur as a
result of receiving an application for enrolment and cannot be refunded:

a. Administration Fee: Administration fees meet the cost of processing an international student application. Administration
fees exist whether an application is accepted or not or whether a Student remains enrolled after an application is
accepted.
b. Insurance: Once insurance is purchased, the School is unable to refund insurance premiums paid on behalf of a student.
Students and Parents may apply directly to an insurance company for a refund of premiums paid.
c. Homestay Placement Fee: Homestay placement fees meet the cost of processing a request for Homestay
accommodation by the student. Costs incurred for arranging Homestay accommodation for the Student prior to the
refund request cannot be refunded.
d. Used Homestay Fees: Homestay fees paid for time the Student has already spent in a Homestay cannot be refunded.
Used Homestay fees may also include a notice period of two weeks.
e. Portion of Unused Tuition Fees: The School may retain a portion of unused tuition fees. Amounts retained will relate to
costs that have been incurred or committed by the School and may vary.

Requests for a refund for failure to obtain a study visa

4. If the Student fails to obtain an appropriate visa, a refund of international student tuition fees will be provided less any
administration fee that has been paid. Evidence must be provided to the school of Immigration New Zealand declining to grant a
visa.
Requests for a refund for enrolment of one term or less:
5. Where the Student is enrolled for one term or less and withdraws early, either before or after the start date of enrolment, other
than where they have failed to obtain an appropriate visa and have provided evidence of this, there will be no refund of tuition
fees or other relevant non-refundable fees.

6. Where the School terminates the enrolment of a Student enrolled for one term or less, there will be no refund of tuition fees, or
other relevant non-refundable fees.
Requests for a refund for voluntary withdrawal from enrolment of more than one term:

7. If the Student voluntarily withdraws 21 days or more before the start date of enrolment, a refund will be provided less any non-
refundable fees as outlined in this policy. The 21 days will be counted from the day after the School receives written notice of the
Student’s intention to withdraw from enrolment.

8. If the Student voluntarily withdraws less than 21 days before the start date of enrolment, other than where they have failed to
obtain an appropriate visa and have provided evidence of this, a refund will be provided less a minimum of 10 weeks’ tuition fees
and any other relevant non-refundable fees as outlined in this policy. The 21 days will be counted from the day after the School
receives written notice of the Student’s intention to withdraw from enrolment.
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 9. If a Student voluntarily withdraws after enrolment has commenced, a minimum of 10 tuition weeks’ notice is required. The notice
period will begin the day after the School receives written notice of the Student’s intention to withdraw from enrolment and the
student may continue to attend school during the notice period.

Requests for a refund where the School fails to provide a course, ceases as a signatory, or ceases to be a provider:

10. If the School fails to provide the agreed course of education or is no longer a signatory to the Code or no longer operates as an
international education provider, the School will negotiate with the Student or their family to either:

a. Refund the unused portion of international student tuition fees or other fees paid for services not delivered, or
b. Transfer the amount of any eligible refund to another provider, or
c. Make other arrangements agreed to by the Student or their family and the School.

11. For the avoidance of doubt, this clause does not apply where the format of the education provided by the School changes (for
example delivery by remote learning), but where the School continues to offer education for international students.
Other circumstances where a refund request may be considered:
Where a student’s enrolment is ended by the School

12. In the event the Student’s enrolment is ended by the School for a breach of the contract of enrolment or as a consequence of a
Welfare Issue, then the School will consider a request for a refund less:

a. Any non-refundable fees set out in this policy;

b. A minimum of ten weeks tuition fees from the date of termination; and
c. Any other reasonable costs that the School has incurred in ending the Student’s enrolment

Where a Student changes to a domestic student during the period of enrolment

13. If a Student changes to a domestic student after enrolment has commenced, a minimum of 10 tuition weeks’ notice is required.
The notice period will begin the day after the School receives written notice that the Student has obtained a visa permitting them
to change to domestic-student status.

Where a Student voluntarily requests to transfer to another signatory

14. If a Student requests to transfer to another signatory after the commencement of their enrolment, a minimum of 10 tuition
weeks of prior notice is required. The notice period will begin the day after the School receives written notice that the Student
requests to transfer to another signatory.

Refund of other fees

Requests for a refund of Homestay fees

15. If for any reason, the Student withdraws after their stay in a School Homestay, any unused Homestay fees will be refunded, less
any relevant non-refundable fees set out in this policy.
16. Where the Student moves from a School Homestay and requests a refund of any unused homestay fees, these will be refunded
less any non-refundable fees set out in this policy.

Requests for a refund of fees unused at the end of enrolment

17. Except by written request from a Student or their Parent, prepaid fees unused at the end of enrolment will be refunded into a
nominated bank account. This should be the bank of origin unless less than $2,000.00

Outstanding activity fees or other fees

18. Any activity or other fees incurred by the Student during enrolment and owed to the School at the time of withdrawal, will be
deducted from any eligible refund.

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Refunds to be made to the country of receipt

19. Unless otherwise agreed in writing, all eligible refunds of fees of NZD$1,000 or more received from outside of New Zealand will
be refunded to a nominated bank account in the source country.

Rights of families after a decision regarding a refund has been made

20. A decision by the School relating to a request for a refund of fees will be provided to the student or Parent in writing and will set
out the following information:

a. Factors considered when making the refund decision;

b. The total amount to be refunded; and
c. Details of non-refundable fees.

21. In the event the Student or the Parent is dissatisfied with a refund decision made by the School or is dissatisfied with the process
the School followed when making the refund decision, they have the right to have the refund decision reviewed by the International
Student Disputes Resolution Scheme or to make a complaint to the Code Administrator.

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PART THREE:

PLEASE COMPLETE THE INTERNATIONAL STUDENT ACCOMMODATION AGREEMENT ONLY IF THE STUDENT WILL BE LIVING IN A
HOMESTAY WHILE ENROLLED AT THE SCHOOL.

INTERNATIONAL STUDENT ACCOMMODATION AGREEMENT

(When placing a student in a School Approved Homestay)
Terms and Conditions:

1. For the purposes of this Agreement the following terms 2. The School is a signatory to and complies with the Code.
shall Unless living with a parent, every international student
have the following meanings: is required to live at an Accommodation approved by
the School in line with the requirements of the Code.
Accommodation means the residential accommodation
provided to the Student under to this Agreement. 3. The Parents and Student agree to the following terms and
conditions of the Accommodation:
Accommodation Requirements means the rules and
requirements of the Accommodation as set out in (a) The School agrees that all information
Schedule One. regarding the Residential Caregiver, the
Parents and the Student relating to the
Agreement means this Accommodation Agreement Accommodation will be kept confidential,
between the Student, School, and Parents which governs except disclosure:
the Student’s Accommodation arrangements.
(i) To the Student, the Parents or Residential Caregiver
Application Form means the standard enrolment (as the case may be);
application form.
(ii) To any professional consultant or such person where
Code means The Education (Pastoral Care of Tertiary and it is in the interests of the Student to provide the
International Learners) Code of Practice 2021 as updated information;
from time to time and available online at
[Link] under Education (Pastoral Care of (iii) According to any statutory or other legal duty.
Tertiary and International Learners) Code of Practice 2021.
(b) The Parents agree that if behaviours or
Contract of Enrolment means the agreement between the conditions of the Student emerge after
Student, the School and the Parents which governs the placement with a Residential Caregiver such
Student’s Tuition. that the Residential Caregiver is unable to
provide the level of accommodation or care
Homestay has the meaning as set out in the Code. required for the safety and wellbeing of the
Student, the School may terminate this
Parents means the Parents referred to in the Application Agreement.
Form.
(c) The Parents or the Student have the right under
Residential Caregiver means the person responsible for the Privacy Act 2020 to see and request
the Student at the Accommodation. corrections of any personal information held by
the School concerning them in relation to the
Residential Caregiver Agreement means an agreement Student’s placement with a Residential
between the School and the Residential Caregiver. Caregiver.

School means the school referred to in the Contract of (d) Under the Privacy Act 2020, any information
Enrolment. collected may be provided to education
authorities.
Student means the International Student residing at the
Accommodation as referred to in the Application Form. (e) These terms and conditions may be changed by
the School (acting reasonably) upon reasonable
Tuition means the education of the Student at the School notification from time to time and will continue
or, in appropriate circumstances, education provided to to apply until notified otherwise.
the Student by the School through online, remote or
distance learning. 4. If the Parents provide misleading information or fail to
disclose information about the Student prior to
All other terms have the same meaning as in the Contract placement with the Residential Caregiver and during
of Enrolment. the term of the Homestay the School may (in its sole
discretion):
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 10. The School may take such measures as it considers
(a) Charge the Parent such fees as required to pay appropriate (acting reasonably) to monitor compliance with
for extra requirements due to providing the Code. This may include regular check-ins with both the
misleading information or the lack of Student and the Residential Caregiver.
disclosure; or
11. Unless otherwise agreed in writing, the Student will be
(b) Terminate this Agreement. entitled to start their Homestay at the Accommodation 5
days before the Period of Enrolment (as that term is defined
5. The initial appointment and ongoing engagement of the in the Contract of Enrolment) starts and 5 days following
Residential Caregiver is subject at all times to: the end date of the Period of Enrolment (as that term is
defined in the Contract of Enrolment). Should this
(a) the Residential Caregiver and the School Agreement be terminated before the expiry of the Period
entering into a Homestay Carer Agreement or a of Enrolment the Student will be required to move out of
Designated Caregiver Agreement; and the Accommodation immediately. The School may, at its
sole discretion, and without being required to do so, extend
(b) the School’s usual requirements and policies the time for the Student to move out of the
relating to the Accommodation. Accommodation. Any such extension shall be given in
writing and shall be without prejudice to the School’s right
6. The School will ensure that to the best of its ability: to later insist that the Student immediately move out of the
Accommodation.
(a) The Accommodation provides a safe, positive
and healthy environment for the Student and Expectations
complies with the Code;
12. The Student will comply at all times with the
(b) The Residential Caregiver’s appointment has Accommodation Requirements and the Parents shall work
not involved any form of gift (financial or with the School to ensure such compliance.
otherwise) to or from a third party;
13. In the event that the Student is removed from a Residential
(c) The appointment of the Residential Caregiver Caregiver for any reason, the School will take all reasonable
does not represent any actual or perceived steps to find, over a reasonable period of time (as
conflict of interest, and that any possible determined by the School in its absolute discretion),
conflict of interest has been notified to the appropriate alternative approved Accommodation for the
School; Student.

(d) The Residential Caregiver will take all 14. The Student will treat the Accommodation with due care
reasonable steps to ensure the Student’s and respect and the Student is liable for costs associated
compliance with New Zealand laws (including, with repairing any damage caused to the Accommodation
where appropriate, informing the Student of by the Student. For avoidance of doubt, the School is not
such laws), and will immediately report any responsible for any damage caused to the Accommodation
possible legal breach to the School; and by the Student.
Fees
(e) The Student only engages in lawful, responsible
and positive recreational activities outside of 15. The Parents must pay all accommodation fees to the School
School. according to the School‘s fee schedule as defined in the
applicable Contract of Enrolment.
7. Unless otherwise agreed in writing by the parties, the Parents
agree for the Student to travel and stay overnight within New Termination
Zealand in the care of their Residential Caregiver for not more
than seven days where the travel does not involve the 16. The School reserves the right to terminate this Agreement
Student participating in any adventure activities or extreme if the Student is in breach of the Accommodation
sports, or result in the Student missing any scheduled school Requirements.
days.
17. If the Student is suspended, expelled or excluded from the
8. The School will seek specific written agreement from the School, the parties agree that this shall constitute a breach
Parents for travel or overnight stays of more than seven days of the Accommodation Requirements and this Agreement
or that results in the Student missing any scheduled school may be terminated as a consequence.
days.
18. Where this Agreement is terminated, fees may be refunded
9. The Student will seek specific written agreement from the according to School Policies.
School before the Student, being a Student of any age,
participates in any activities which are considered to be General
adventure activities or extreme sports. The School will only
give such Agreement where approved by the Parents. 19. This Agreement shall be construed and take effect
according to the non-exclusive laws of New Zealand. In
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 relation to any legal action or proceedings arising out of or
in connection with this Agreement, the Parents: 22. The parties acknowledge that prior to signing this
Agreement, they have had the opportunity to seek
(a) submit to the non-exclusive jurisdiction of the independent legal advice about its content and effect.
Courts of New Zealand; and

(b) agree that proceedings may be brought before Disputes

any Court including any forum constituted
under the Arbitration Act 1996 within New 23. The parties agree that any dispute in relation to this
Zealand, and waive any objection to Agreement will be resolved according to the Code and the
proceedings in any such Court or forum on the School Policies.
grounds of venue or on the grounds that the
proceedings have been brought in an
inconvenient forum.

20. Notices given under this Agreement must be in writing and

given to the addresses set out in the Application Form.
Those sent by post will be considered to have been received
ten (10) days after posting. The Parties agree that email
correspondence is a suitable means of communication and
emails will be considered to have been received when
acknowledged by the party or by return email.

21. This Agreement contains the entire understanding of the

parties and overrides any prior promises, representations,
understandings or agreements.

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 Accommodation Requirements
(Schedule One)

While living in a School approved Homestay, the Student agrees:

1. To comply with all laws of New Zealand.

2. Not to engage in any social or leisure activities that may place them or other persons, in undue danger or risk of harm. This includes
the Student putting himself / herself in a position which may give rise to suspicions or allegations of such activities.

3. To obtain written permission from Parents and the School prior to obtaining any tattoo, piercing or other bodily embellishments.

4. To comply with all Homestay rules, expectations and curfews set by the School and Homestay parents, including any policies of the
School which apply.

5. To not use or not do anything which may cause damage to the Accommodation, including applying hair dyes, or smoking cigarettes
or engaging in any other activity that may cause damage to the Accommodation.

6. To keep the Homestay parents informed of their whereabouts at all times.

7. To stay at the Homestay address daily and not to travel overnight outside of the town or city (as defined by the School) where the
student is living without prior written permission of the School. This clause shall not prevent the Student travelling between the
Homestay and the School.

8. To respect the privacy, values and property of the Homestay.

SIGNING

Parents
By signing below, the Parents confirm that they have read the Agreement and agree to be bound by it in all respects (initial each page):

Name(s): ___________________________________

___________________________________

Signature(s): ___________________________________

___________________________________

Date: ___________________________________

School
By signing below, the authorised signatory of the School confirms that they are authorised to sign on behalf of the School, and confirms
that the School will be bound by the Agreement in all respects:

Name: ___________________________________

Signature: ___________________________________

Date: ___________________________________

Student
By signing below, the Student confirms they have read and understood the Agreement and agrees to abide by the Code, the School Policies
and (to the extent applicable) the Agreement:

Name: ___________________________________

Signature: ___________________________________

Date: ___________________________________
Initialled by: __________________(parent) ____________________(student) 19

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 Initialled by: __________________(parent) ____________________(student) 20

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PART FOUR:

PLEASE COMPLETE THE DESIGNATED CAREGIVER AGREEMENT ONLY IF THE STUDENT WILL BE LIVING WITH A DESIGNATED CAREGIVER
WHILE ENROLED AT THE SCHOOL.

DESIGNATED CAREGIVER AGREEMENT

This is an agreement between the Parent/s, the Designated Caregiver/s and the School (the Agreement).

School name: __________________________________________ (the School)

Student’s name: __________________________________________ (the Student)

Name of parent one: _________________________________________

Name of parent two: ___________________________________________ (together the Parents, each a Parent)

Name of caregiver one:

(relative or close family
friend): ___________________________________________

Name of caregiver two:

(eg partner of relative or
close family friend): ___________________________________________ (together the Designated Caregivers, each
a Designated Caregiver)

Address: _____________________________________________

____________________________________________ (the Residence)

AGREEMENTS

1. The Student and the Parents are parties to a Contract of

Enrolment with the School. All definitions contained in that 6. Approval is required from the School before the Student is
Contract of Enrolment are considered to form part of this placed with the Designated Caregiver/s.
Agreement so far as they are relevant.
7. The Designated Caregiver/s agree that approval will be
2. The Parents agree that the Designated Caregiver/s will provided only after appropriate safety and other checks
provide residential care for the Student while enrolled as an have been completed by the School in accordance with the
international student at the School. Code and School policies.

3. The School has provided, and the Designated Caregiver/s

have read and understood, the sections of The Education 8. Failure by the Designated Caregiver/s to provide the
(Pastoral Care of Tertiary and International Learners) Code residential care required by the School and the Code may
of Practice 2021 (the Code) relevant to residential caregivers result in the School’s approval of the Designated Caregiver/s
and the School’s Information for Designated Caregivers and being withdrawn.
agree to act as Designated Caregiver/s to the Student
according to these requirements. 9. The Designated Caregiver/s agree to support the Student to
abide by all rules and expectations set by the School.
4. For the avoidance of doubt, The Designated
Caregiver/s agree that the accommodation provided is 10. In the event the School withdraws its approval of the
caring, safe, positive, is a healthy environment, and supports Designated Caregiver/s, the Agreement is terminated, and
the Student to achieve their academic goals. the Student will be placed in alternative accommodation
approved by the School at the full cost and expense of the
5. The School agrees that all information regarding the Parents.
Designated Caregiver/s relating to the Agreement will be
kept confidential, except disclosure to the Student or their 11. The School may take such measures as it considers
parents, to any professional consultant or such person appropriate (acting reasonably) to monitor and review the
where it is in the interests of the Student to provide the quality of residential care by the Designated Caregiver/s and
information or according to any statutory or other legal duty. this may include regular visits to the Designated Caregiver/s
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 and meetings with both the Student and the Designated and respect and the Student is liable for costs associated
Caregiver/s. with repairing any damage caused to the Accommodation by
the Student. For avoidance of doubt, the School is not
12. The Designated Caregiver/s will provide the School with responsible for any damage caused to the Accommodation
fourteen days (14) days prior notice of any change in by the Student.
circumstances that may affect the Agreement. This includes
any change of Residence or any change to the number of
adults living at the Residence. For the avoidance of doubt, 15. The parties agree that any dispute in relation to this
an adult is a person 18 years of age or older. Agreement will be resolved in accordance with the Code and
the School policies.
13. The Parent/s agree that the School is not responsible for the
Student’s day-to-day care while in the care of the Designated 16. This Agreement may be signed in one or more counterparts,
Caregiver/s. each of which when so signed and all of which together shall
constitute one and the same Agreement. Delivery of signed
14. The Student will treat the accommodation provided by the
counterparts may be delivered by email or facsimile
Designated Caregiver/s (“Accommodation”) with due care transmission.

SIGNING

By signing this agreement the Student, the Parent/s and the Designated Caregiver/s declare that the Designated Caregiver/s are eligible to
be a Designated Caregiver under the Code (being someone who is personally known to the Student and/or Parent(s) as a relative or close
friend and meets the other requirements of the Act and the Code).

PARENT/S:

By signing below, the Parent/s confirm that they have read the Agreement and agree to be bound by it in all respects: (please initial each
page)

Name: ________________________________ Signature: _________________________

Name: ________________________________ Signature: _________________________

Date: ________________________________

DESIGNATED CAREGIVERS:

By signing below, the Designated Caregivers confirm they have read the Agreement and agrees to be bound by it in all respects:

Name: _________________________________ Signature: _______________________________ Date: ____________________

Name: _________________________________ Signature: _______________________________ Date: ___________________

SCHOOL:

By signing below, the authorized signatory of the School confirms that they are authorized to sign on behalf of the School and confirms that
the School will be bound by the Agreement in all respects:

Name: _____________________________________ Signature: ______________________________ Date: ____________________

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