Pre-Application Form – SPCNM Enrolment

I am applying to enrol at SPCNM for the first time

Personal Details

First Name*

Last Name*

Date of Birth*

Gender*

What is your main occupation currently?*

Contact Details

Home Phone

Mobile*

Personal Email*

City/Region*

Education

Will this be your first Year of Tertiary education?*

What year was your first enrolment?

What qualification were you awarded?*

Please list all of the tertiary qualifications you hold, the month and year you completed each and the tertiary education organisation that it was completed at.

Language

What is your first language?*

Qualification

I am applying to enrol in the following qualification*

What Personal Interest course are you interested in studying?

Select one of the following modes of study*

Will you be studying in NZ or overseas?*

In New Zealand
Overseas

Comments

Recognised Prior Learning (RPL) or Credit Recognition Transfer (CRT)

Please indicate the courses for which you may request RPL or CRT.
Full instructions will be provided.

Courses

Comments

Declaration

Signature*

Type your name

Date