Application form Thank you for applying to be an ESOL home tutor with English Language Partners. Select a centre*Select a centreAuckland North ShoreAuckland Central & WestAuckland SouthBlenheimChristchurchDunedinHamiltonInvercargillLevinLower HuttNapierNelsonNew PlymouthPalmerston NorthPoriruaRotoruaTaupoTaurangaTimaruWellingtonWhanganuiWhangareiName* First Last Contact phone (home)Contact phone (work)Contact phone (mobile)Email* Address* Street Address Address Line 2 City ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Date of birth DD MM YYYY Gender*MaleFemaleDiverseEthnicity*First language*Other language(s)Name of emergency contact person*Number of emergency contact person*Work status*Full timePart timeStudentHomemakerSelf-employedRetiredUnemployedOtherPresent occupation*Days/times available*Mode of transport to learner*Life experience (i.e. family, travel, work, qualifications)*Personal interests and preferences (e.g. ethnicity, language level, do you mind if children are present at lessons?)*Special information (Eg. Health)How did you hear about English Language Partners?*AdvertisementFacebookEmailWebsiteWord of mouthOther ESOL home tutorConnecting Cultures magazineLocal paperVolunteer centreI agree to provide the names and contact addresses / phone numbers of two people (other than family members) who are able to act as my referees.Referee 1:NameAddressPhoneEmail What is your relationship with this referee?Referee 2:NameAddressPhoneEmail What is your relationship with this referee?(Tick to agree)* I give permission for English Language Partners New Zealand to hold the above information about me in accordance with the Privacy Act, 2020, and understand that some details will be passed on to the National Office for accountability purposes for Government funding and for general communications. I may see any information held about me and amend any errors in that information. * I give permission for my email address to be used by English Language Partners to inform me of its activities. I understand English Language Partners will not pass my email address to any other organisation. * I have declared any criminal convictions (not excluded by the Clean Slate Act 2004) and/or any criminal charges pending in New Zealand or any other country. * I understand my application to take part in this course or be matched with a learner may be declined and that this decision is final. * I understand that there may be a one-off charge of $40 to cover course book and materials costs. * I confirm the information I have provided is correct. Statutory information statement for students required under section 234B of the Education Act: There is a $40NZD fee for this course to cover training materials etc. Check your centre's webpage for details. No governing members of English Language Partners New Zealand have material conflicts of interest.