Universal Education Group Limited trading as New Zealand National College 2008 Level 3 238 Queen Street Auckland Central New Zealand Tel.: +64 (9) 379 9330 email: [email protected]

Enrolment Form – FOR APPLICANTS UNDER 18 YEARS OF AGE Applicant Personal Details Family Name:

Given Name:

- MM -

Date of Birth:

YYYY

DD

Identification:



NZNC’s Student ID Card



NZNC Student ID number:



Passport



NZNC will need to sight and keep a copy of your passport and visa details

English name:



Gender:



M

F

Applicant Contact Details Mobile:

(

)

email:

Address:

Proposed Study Programme

Authorised Agent’s Stamp

 University Preparation

 credit value required:

agency name

 General English

 number of weeks:

name of agent

 IELTS Exam Preparation

 number of weeks:

mobile

 Business

 please state level:

email

Destination Intention – on completion, I’d like to… …  Staircase to higher level programmes within NZNC

Off-shore Applicant Assistance Tick () if you require assistance in the following:

arrival date

 Pathway to:

Airport pick-up

 Obtain employment or start my own business

Home-stay arrangement

Overseas Education – please state the highest level of secondary schooling you have completed overseas Level:

School:

Country:

Year:

New Zealand Education – please advise of any studies you have started/completed in New Zealand Name of School / Institute

Name of Programme and NZQF Level

Calendar Year

Status

Insurance – By law international students shall have travel and medical insurance coverage at all times while enrolled at NZNC. 

I currently have valid insurance coverage. 

Please attach a copy of your insurance certificate with your application



I shall arrange for my own insurance.



NZNC must sight your insurance certificate before commencing studies



Please arrange and invoice me for travel and medical insurance coverage of

months.

Enrolment Form UNDER 18 last updated 2017-01-09 © Universal Education Group Limited trading as New Zealand National College 2008 – All rights reserved 2017.

Universal Education Group Limited trading as New Zealand National College 2008 Level 3 238 Queen Street Auckland Central New Zealand Tel.: +64 (9) 379 9330 email: [email protected]

Particulars of Applicant’s Parents Full name in English or ethnic script

email

Mobile number

Father:

(+

)

Mother:

(+

)

Overseas Address:

Particulars of Guardian and/or Designated Residential Caregiver Family Name:

Given Name:

Date of Birth:

YYYY

Nature:



Mobile:

(

- MM -

Duly Appointed Guardian )

DD

English name:



Gender:



M



F

Designated Residential Caregiver

email:

Address:

Declaration – make sure you read all the bullet points below and all information it refers to before you sign!  

  

 

  

 

I understand my obligation to be a genuine student and shall study industriously, prioritising my studies and personal wellbeing above all else. I must reside with the guardian appointed by my parents or a designated residential caregiver as notified to NZNC. I understand my enrolment shall be terminated immediately without compensation if found to have a different living arrangement without prior approval from NZNC. I confirm that all information supplied to NZNC is complete, true and accurate. I have disclosed all relevant personal circumstances to NZNC, such as but not limited to, any disability (physical, mental or learning related). I understand I have an obligation to inform NZNC should there be any changes to the information I supplied while my application is being processed, while pending commencement of my studies, and throughout my enrolment with NZNC. I agree to have my enrolment terminated immediately without compensation if I made a false declaration here below. I have read and understood the following information given to me by NZNC or its authorised agency/agent: Enrolment Terms and Conditions; external evaluation and review results and category of NZNC; direction to the Education (Pastoral Care of International Students) Code of Practice 2016 online; complaints and dispute resolution process; programme details, learning outcomes and pathways available on completion; facilities, equipment and support services available to learners; full costs disclosure; refund policy; immigration requirements; visa requirements; NZNC’s duty to report to educational and immigration authorities; and a privacy statement for enrolment application. I agree to the NZNC’s terms and conditions for enrolment; and to abide by all NZNC’s policies. I authorise NZNC to disclose my information to any government authorities as required by law. I authorise the release of information from New Zealand immigration authorities to NZNC in relation to my visa application relevant to this enrolment application. This includes, but is not limited to, the reason for the decline of my visa application (in the event my visa application is declined). I authorise NZNC to contact my parents in the event of an emergency or when there are concerns with my wellbeing. I acknowledge NZNC cannot be held responsible for my actions outside NZNC’’s campus and that my guardian and/or designated residential caregiver has the responsibility instead. Applicant signature:

Date:

YYYY

-

MM

-

DD

Parent/Guardian consent:

Date:

YYYY

-

MM

-

DD

Enrolment Form UNDER 18 last updated 2017-01-09 © Universal Education Group Limited trading as New Zealand National College 2008 – All rights reserved 2017.

Universal Education Group Limited trading as New Zealand National College 2008 Level 3 238 Queen Street Auckland Central New Zealand Tel.: +64 (9) 379 9330 email: [email protected]

(detach and give to applicant) Selected important information – please read carefully alongside other information given to you 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

12. 13.

Application to enrol is subject to NZNC’s assessment and evaluation of applicant’s credentials, including English language proficiency. Application, enrolment and ongoing enrolment is subject to NZNC’s policies, terms and conditions,. Enrolment is subject to applicant receiving and accepting an unconditional offer from NZNC; payment of all fees invoiced; presentation of a valid visa for immigration purpose; and adequate coverage of travel and medical insurance. Applicant must disclose all relevant personal circumstances to NZNC, such as but not limited to, any disability or criminal conviction. Provision of false information or withholding of relevant information may result to immediate termination of enrolment without compensation (subject to statutory minimum requirements). Applicant must advise NZNC of any changes of personal circumstances and/or any changes to the information supplied to NZNC. The email addresses supplied on this form, or any email address notified to NZNC as a result of change, shall be the applicant’s primary and legal contact. Applicant’s parent(s) and/or guardian shall also be notified of the outcome of this application. While NZNC endeavours to accommodate any preferences expressed by its learners, NZNC has the professional judgement and ultimate right in decisions of class allocation, lecturer allocation, classroom allocation, campus allocation and determination of a learner’s level of English. NZNC has a duty to inform immigration authorities for any unresolved concerns in attendance and/or academic performance. NZNC is a signatory to the Education (Pastoral Care of International Students) Code of Practice 2016 – a copy of this regulation and associated support documents can be accessed online via NZQA’s website: http://www.nzqa.govt.nz/providers-partners/education-code-of-practice/ NZNC is a registered privately-owned and operated tertiary institute (known as a “private training establishment”, or “PTE” in short, under the Education Act 1989. Its performance and self-assessment is subject to periodic external evaluation and review by NZQA. NZNC is currently a category 2 institute – NZQA is confident in both the performance and self-assessment of NZNC. Under 18 years old must reside with a designated residential caregiver, who may or may not be the guardian appointed by the applicant’s parents. Under 18 years old are not allowed to reside on their own or have alternative living arrangements without NZNC’s prior approval. NZNC cannot be held responsible for any actions by a learner under 18 years of age outside NZNC’s campus. The guardian appointed by the applicant’s parents and/or the designated residential caregiver has the responsibility instead.

Privacy Statement NZNC collects personal information from you, including but not limited to, your contact and personal identification details, in order to assess and evaluate your application to enrol; to provide continuous support to you if your application for enrolment is approved; as well as to meet statutory requirements in record-keeping as monitored by educational and immigration authorities. Beyond NZNC, your information (either supplied by you or generated during your enrolment with NZNC) may be shared with NZQA and Immigration New Zealand as required by law. NZNC keeps your information for at least EIGHT (8) years on file and/or electronically. Hard copies of documents are destroyed by outsourced secured document destruction service. You have the right to ask for a copy of any personal information NZNC holds about you and ask for it to be corrected if you believe it is wrong. If you’d like to ask for a copy of your information or to have it corrected, please contact NZNC via email to [email protected] or inperson at NZNC’s office as listed on the top of this application form.

Enrolment Form UNDER 18 last updated 2017-01-09 © Universal Education Group Limited trading as New Zealand National College 2008 – All rights reserved 2017.