Step 1 - Course Details
Course of interest
Preferred Start Date (DD/MM/YYYY)
Course Fee: NZ$
Step 2 - Personal Details
Surname (as shown on your passport)
*
First Name/s
*
Date of Birth (DD/MM/YY)
Citizenship
Passport Number
Postal Address
Country
Native Language
Telephone
E-mail
*
Step 3 - Other Details
Emergency Contact
Name
Relationship
Telephone
Email
Prior Activity
What was your MAIN activity or occupation at 1 October last year
Disability (The information you supply is confidential)
Please state any medical condition that may affect your training
Step 4 - English Proficiency
If English is not your first language, please indicate your level of English proficiency
IELTS or TOEFL Score
Please write a short essay (around 100 words) explaining why you are interested in the chosen programme of study and why you wish to study in New Zealand. If you have completed previous studies in that field, or if you have relevant work or life experience, include these details as well.
Step 5 - Insurance & Accommodation
Medical Insurance
Travel and medical insurance is compulsory for international students studying in New Zealand. The insurance can be arranged for you (additional fees apply). Evidence will be required if a student has already arranged their own insurance, which needs to meet the guidelines set out in the Code of Practice. Please indicate if insurance is required:
Accommodation
Full board homestay with carefully selected host families can be arranged for you in Kerikeri.
In Auckland, we use the homestay agency Host Families NZ. Quantum can put you in touch with the agency to arrange the booking.
An application placement fee of NZ $200 applies. Alternatively students can arrange their own accommodation.
Do you have any allergies? If yes, please list them
Do you have any special dietary needs? (e.g. Vegetarian, Halal)
What are your interests and hobbies?
Step 6 - Academic & Vocational
Secondary School
What was your last year at secondary school?
What is the highest level of achievement you hold from a secondary school?
Tertiary Study
If “No,” please provide the year of your first enrolment in a tertiary institution
Step 7 - Checklist
Marketing Information
How did you find out about the programme that you are enrolling in?
Agency Name (if applicable)
Contact Person
Checklist
Step 8 - Declaration
Privacy Quantum Education Group collects and stores information from this form to comply with the requirements of the Ministry of Education (student statistical returns), New Zealand Qualifications Authority (Record of Learning registration and Unit Standard outcomes), Tertiary Education Commission (funding returns), Industry Training Organisations (funding and academic outcomes), Ministry of Social Development (confirmation of enrolment and academic outcomes), Inland Revenue Department (student loan interest rebate), Department of Immigration (if you are not a New Zealand citizen or permanent resident) and Agencies who support particular students through scholarships and prizes, payment of fees or other awards (if you are a recipient of one of these awards).
The information is also used to select students for qualifications, to manage internal administrative processes, and for internal reporting. Information about students may be supplied to, and sought from, other educational institutions for the purpose of verifying academic records.
NB The Privacy Act came into force on 1 July 1993 with the stated aim of protecting the privacy of natural persons. It requires Quantum Education Group to collect, hold, handle, use and disclose personal information in accordance with the twelve information privacy principles in the Act. For further information please see http://www.privacy.org.nzpeople/peotop.html.
Please note that your name, date of birth and residency as entered on this enrolment will be included in the National Student Index, and will be used in an Authorised Information Matching programme with the New Zealand Birth Register. For further information see http://www.nsi.govt.nz/ima.
In addition, when required by statute, Quantum Education Group releases information to Government agencies such as the New Zealand Police, Department of Justice, Ministry of Social Development, and the Accident Compensation Corporation (ACC).
In signing this enrolment form you authorise such disclosure on the understanding that Quantum Education Group will observe the general conditions governing the release of information, as set out in the Privacy Act 1993 and the post-compulsory Unique Identifier Code of Practice. You may see any information held about you and amend any errors in that information. To do so, contact the Student Services Manager.
Fees In submitting this enrolment form you undertake to pay all fees as they become due, and to meet any late fees and collection charges associated with debt recovery. Quantum Education Group’s policy on withdrawal and refund of fees has been explained to you.
Rules In submitting this enrolment form you undertake to comply with the published rules and policies of Quantum Education Group with regard to attendance, academic progress, standard of dress, health and safety, and behaviour.