Active Institute Online Enrolment

Online enrolment

You may also download the online form (.PDF), and then fax or post to us.

Step 1. Personal Information:
*Family Name:
*Given Name:
Prefer Name:
*User Name:
*Password:	(4 to 6 characters)
*Confirm Password:
*Gender:	Male Female
*Date of Birth:	(DD/MM/YYYY)
*Email:
*Nationality:
Citizenship:
*Phone:	(e.g. 86-1-2344555)
Fax:
*Postal Address:
Address In New Zealand:
Visa Type:
*Name of next kin:
* Phone of next kin:	(e.g. 86-1-2344555)
*Homestay requirement:	Yes No
Please answering the following questions if you require us to arrange homestay, otherwise please cilck next step button.
Do you Smoke?:	Yes No
Medical Conditions:
Any food you do not eat :
*Airport pick up Requirement:	Yes No
Please answering the following questions if you require us to arrange transportation,otherwise please cilck next step button.
Flight No:
Arrival Date:	(DD/MM/YYYY)
Arrival Time:	(e.g.11:24 am)