The University of Auckland Study Abroad Programme (COPOS) Application OR apply online at www.auckland.ac.nz

1. PERSONAL DETAILS

Family Name

First Name(s)

Preferred Name

Gender Female Male

Title Ms Miss Mrs Mr Other ____________

Citizenship (list all)

Date of birth (dd/mm/yy)

City/country of birth

Do you live with the effects of an injury or long-term illness for which you would need some form of support from this university?

No Yes If yes, please give brief details:

2. ADDRESS DETAILS

Applicant’s Correspondence Address

Number and street

Suburb

City and Postcode

Country

Telephone

Fax

Email address

Next of Kin / Emergency Contact

Name

Relationship

Number and street

Suburb

City and Postcode

Country

Telephone and mobile

3. CURRENT PROGRAMME DETAILS

Home University

Current year of study

Office Use

Only

Attach a colour, passport-sized

photo (45 x35mm) here

using a paper clip. DO NOT glue

or staple.

Updated on 08/05/2008

GFAssistTextfeldinfo@ieconline.de

GFAssistTextfeld+49-30-20458688

GFAssistTextfeld+49-30-20458687

GFAssistTextfeldGermany

GFAssistTextfeld10117 Berlin

GFAssistTextfeldc/- IEC Online GmbH, Marienstrasse 19-20

Expected year of graduation

Specialisation or Major

List the courses/papers

Currently enrolled

Proposed period of study Semester One (March – June ) _________ Year _________

Semester Two ( July – Nov ) _________ Year _________

Proposed courses/papers at The University of Auckland

4. ENGLISH LANGUAGE PROFICIENCY All applicants are required to provide evidence of their proficiency in the English language. The University’s preferred measure is IELTS (minimum = overall band score of 6.0 in the Academic Module, with no band less than 5.5). TOEFL is also acceptable (minimum paper-based 550 or computer-based 213, with TWE of 4.5). Higher scores may be required for admission to some programmes.

Is English your first language?

IELTS results

(Academic)

TOEFL results TWE

Date of test

Yes NO

Please note: Applicants whose first language is not English but who have been taught and gained relevant qualifications in the English-language medium may on a case by case basis provide a written statement to that effect issued from the degree-granting institution. Please contact Auckland International for specific details. 5. DECLARATION I promise to abide by the Statues and Regulations and comply with the reasonable requirements of The University of Auckland as published in the University Calendar. I declare that the information set out in this application form and attached documents is complete and correct, and I acknowledge that the University may cancel my enrolment if false information has been supplied or if information required is not supplied by the due date. I have read and understood the outline of how the Privacy Act 1993* will be applied to the information I supply, and I authorise the University to collect, use and disclose personal information about me in accordance with that outline and the Privacy Act 1993. I understand that if I apply for a Student Allowance or a Student Loan, the University may disclose relevant personal information to the StudyLink for the administration of those schemes. I authorise The University of Auckland to make amendments to my proposed study where such amendments are necessary to comply with degree regulations and requirements. I authorise any agency holding the source of information I have provided on this form to release that information to the University on request. Signature ____________________________________________ Date _____________________ (dd/mm/yy) *Information on the Privacy Act 1993 is available at www.auckland.ac.nz/security/PrivacyAct1993.htm 6. CHECKLIST OF REQUIRED MATERIALS (FOR STUDENT USE ONLY) Incomplete applications cannot be processed. Please tick to show that you have enclosed the following:

Completed application with the correct programme of COPOS Official academic transcript showing current (and previous, if applicable) undergraduate and/or postgraduate

studies at University Evidence of your legal name, date of birth and citizenship (e.g. verified copy of passport or birth certificate) A colour passport-sized photograph of yourself (45mm height ×35mm width) Verified evidence of English language proficiency, if applicable

“Verified” means document is signed, dated and stamped by an official from your University, Justice of the Peace, solicitor or notary public Return this form, with all supporting documentation, in one envelope, to:

Updated on 08/05/2008

http://www.auckland.ac.nz/security/PrivacyAct1993.htmGFAssistStempel

1. Personal DetailsFamily NameFirst Name(s)Preferred NameGender Female MaleTitle Ms Miss Mrs Mr Other ____________Citizenship (list all)Date of birth (dd/mm/yy)City/country of birthDo you live with the effects of an injury or long-term illness for which you would need some form of support from this university?No Yes If yes, please give brief details:

2. Address Details Number and street

3. CURRENT Programme Details4. English Language Proficiency5. Declaration6. Checklist of Required Materials (for student use only)