Application Form

To apply for the New Zealand Reading Safari, complete and submit this application form to us. We must receive your application form before the closing date listed under the details for this years program.

You will also need to post to us the following:

  • Three passport-sized photos
  • A letter from your school verifying that you are a teacher
  • Your deposit check (bank draft for $500 US dollars)

Your application will only become registered once these items have been received. 
They can be posted to: 

INTERead New Zealand Ltd
PO Box 12 118
Wellington
NEW ZEALAND
Fax 011-64-4-4758788
Name:
Address:
Phone:
Fax: (fax or email address required)
E-mail:
Birth Date:
Program: B2 B3 B4
Years of teaching experience:
Age range of students:
Curriculum strengths:
Do you wish to register for Graduate Continuing Study Credits? Yes
No
To help us in your preliminary placement, please briefly outline why you wish to participate in this program
What are your sport and leisure interests?
Are you in good health? Yes
No
Have you been under medical care in the past two years? Yes
No
If your health is likely to be a factor in your placement, please explain
Most host families require guests who do not smoke. Do you smoke? Yes
No
Will you be accompanied by a relative? Yes
No
If so, please complete the following:
Name:
Relationship to you:
Birth date:
Does he/she smoke? Yes
No
In the case of an emergency, who should be notified?
Name:
Address:
Phone:
Relationship:
Please remember to send to us the items listed at the top of this form.
The personal information required by this form is collected, and will be held by INTERead New Zealand Ltd (PO Box 12 118, Wellington, New Zealand) for the purposes of our Reading Safari Program and other developments or matters that we believe will be of interest or relevance to your professional development. You have the right of access to, and the correction of, personal information about you, that we have.