1Contact Details2Education, Language and Nationality3Disability, International Students 4Next of Kin5Qualification & Course Enrolment PERSONAL DETAILSTitleMsMissMrsMrDrWhat is your full legal name?*As shown on your formal identification documents Preferred First Name* Previous Name/s known by: Date of Birth (DD/MM/YYYY)* Gender*FemaleMaleOtherCONTACT DETAILSPhone or Mobile Number* Alternate Phone Number Personal Email* Street AddressStreet Number* Street* Suburb/Town* City/Region Postcode* Country* Postal AddressPO Box Street Number Street Suburb/Town City/Region Postcode Country EDUCATION & EMPLOYMENTNSN (National Student Number) if known: Are you still at school?*YesNoLast School Attended (state Overseas if applicable)*Academy for Gifted EducationACG New Zealand International CollegeACG Parnell CollegeACG Senior CollegeACG StrathallanACG SunderlandACG TaurangaADDI Enrichment AcademyAidanfield Christian SchoolAkaroa Area SchoolAlbany Junior High SchoolAlbany Senior High SchoolAlfriston CollegeAllenvale Special School & Res. CentreAl-Madinah SchoolAl-Madinah SchoolAmana Christian SchoolAmbury Park Centre For Riding TherapyAmuri Area SchoolAmworth Secondary SchoolAorere CollegeAotea CollegeAparima CollegeAquinas CollegeArahunga SchoolAranui High SchoolArohanui Special SchoolAshburton Christian SchoolAshburton CollegeAthena Montessori College (CLOSED)Attended NZ School Not On ListAuckland Girls' Grammar SchoolAuckland GrammarAuckland International CollegeAuckland Metropolitan CollegeAuckland Seventh-Day Adventist H SAurora CollegeAurora Girls' HomeAvon Christian CollegeAvon Christian CollegeAvondale CollegeAvonside Girls' High SchoolAwatapu CollegeAwatapu SchoolAwhina SchoolBaradene CollegeBarnardos SchoolBay Of Islands CollegeBayfield High SchoolBeck HouseBerkley Normal Middle SchoolBethlehem CollegeBethlehem CollegeBirkenhead CollegeBishop Viard CollegeBlind and Low Vision Education Network NBlomfield Special School & Resource CtreBlue Light Senior Boys High SchoolBlue Mountain CollegeBollard Ave Girls' Home SchoolBotany Downs Secondary CollegeBream Bay CollegeBroadwood Area SchoolBuller High SchoolBurnside High SchoolCambridge High SchoolCambridge International CollegeCambridge Middle SchoolCampbell Park SchoolCampion CollegeCarey CollegeCarey College (Secondary)Cargill High SchoolCarlson School (Cerebral Palsy)Carmel CollegeCascade Christian CollegeCashmere High SchoolCatholic Cathedral CollegeCentral Auckland Specialist SchoolCentral Hawkes Bay CollegeCentral Regional Health SchoolCentral Southland CollegeChanel CollegeChapman CollegeCheviot Area SchoolChildren Of Hope New ZealandChilton St James SchoolCholmondeley Home School (Property)Christchurch Adventist SchoolChristchurch Boys' High SchoolChristchurch Boys' Home SchoolChristchurch Girls' High SchoolChristchurch Senior CollegeChristian Renewal SchoolChristian SchoolChrist's CollegeChurch College Of New ZealandCity Impact Church School (Secondary)City Senior SchoolClareville SchoolClendon Teen Parent UnitClover Park Middle SchoolCoastal Taranaki SchoolCollingwood Area SchoolColumba CollegeCornell High SchoolCornerstone Christian SchoolCoromandel Area SchoolCoromandel Street SchoolCraighead Diocesan SchoolCromwell CollegeCullinane CollegeDannevirke High SchoolDarfield High SchoolDargaville High SchoolDe La Salle CollegeDestiny CollegeDestiny SchoolDilworth SchoolDingwall Trust SchoolDiocesan School For GirlsDrury Christian SchoolDunstan High SchoolEast Otago High SchoolEden CampusEden Christian AcademyEdgecumbe CollegeEdgewater CollegeEdmund Rice CollegeEducational UnitEdward Seager SchoolElim Christian CollegeEllesmere CollegeEmmanuel Christian SchoolEpsom Girls Grammar SchoolEpuni Boys' Home SchoolErskine CollegeExcellere CollegeFairfield CollegeFairhaven School (Napier)Feilding High SchoolFelix Donnelly CollegeFerndale School (Christchurch)Fiordland CollegeFlaxmere CollegeForest View High SchoolFour Avenues Alternative SchoolFrancis Douglas Memorial CollegeFraser High SchoolFreyberg High SchoolGarin CollegeGeraldine High SchoolGisborne Boys' High SchoolGisborne Girls' High SchoolGlendowie CollegeGlenelg Health Camp SchoolGlenfield CollegeGlobal Indian International School (ClosGloriavale Christian Community SchoolGolden Bay High SchoolGoldfields School (Paeroa)Gore High SchoolGreen Bay High SchoolGreymouth High SchoolGreymouth Special SchoolHaeata Community CampusHagley Community CollegeHalswell Residential CollegeHamilton Boys' High SchoolHamilton Boys' HomeHamilton Christian SchoolHamilton Christian School (Secondary)Hamilton CollegiateHamilton Girls' High SchoolHamilton North SchoolHamilton's Fraser High School TPUHastings Boys' High SchoolHastings Christian SchoolHastings Christian School (Secondary)Hastings Girls' High SchoolHato Paora CollegeHato Petera CollegeHauraki Plains CollegeHavelock North High SchoolHawera Christian AcademyHawera High SchoolHawke's Bay School for Teenage ParentsHe Huarahi TamarikiHe Mataariki School for Teen ParentsHealth Camp School (Otago-Southland)Hebron Christian College (Auckland)Hebron Christian College (Nelson)Henderson - Teen Parent Unit - He Wero oHenderson High SchoolHeretaunga CollegeHighcliff High SchoolHill Top SchoolHill Top School (Sec Dept)Hillcrest High SchoolHillmorton High SchoolHillview Christian SchoolHobsonville Point Secondary SchoolHohepa Home School (Christchurch)Hohepa Home School (Napier)Hokio Beach SchoolHokitika Christian SchoolHokitika Christian SchoolHome SchoolingHomeleigh Christian School (Closed)Hornby High SchoolHorowhenua CollegeHowick CollegeHuanui CollegeHukarere CollegeHuntly CollegeHurunui CollegeHutt International Boys' SchoolHutt Valley Christian SchoolHutt Valley Christian School (Merged)Hutt Valley High SchoolImmanuel Christian SchoolImmanuel Christian School (Secondary)Inangahua CollegeIndependent Middle School (CLOSED)Inglewood High SchoolInternational Christian SchoolInternational Middle SchoolIona CollegeJames Cook High SchoolJames Hargest CollegeJames Hargest High SchoolJean Seabrook Memorial SchoolJohn McGlashan CollegeJohn Paul CollegeJohn Paul II High SchoolKadimah CollegeKadimah College (Secondary)Kahutia SchoolKaiapoi High SchoolKaikohe Christian SchoolKaikohe Christian School(Secondary)Kaikorai Valley CollegeKaikoura High SchoolKaipara CollegeKaitaia Abundant Life SchoolKaitaia Abundant Life School (closed)Kaitaia CollegeKaka Street Special SchoolKamahi SchoolKamo High SchoolKapiti CollegeKaramea Area SchoolKaramu High SchoolKaranga Mai Young Parents CollegeKatikati CollegeKavanagh CollegeKawerau CollegeKawerau High SchoolKawerau Teen Parent UnitKea Street Specialist SchoolKelston Boys' High SchoolKelston Deaf Education CentreKelston Girls' CollegeKerikeri Christian Community SchoolKerikeri Christian SchoolKerikeri High SchoolKia Aroha CollegeKimi Ora SchoolKimihia Parents' CollegeKing Edward International High SchoolKings Christian School (Secondary)Kings CollegeKings College (Christchurch)Kings High School (Dunedin)Kingslea SchoolKingsway SchoolKingsway Secondary SchoolKingswell High SchoolKohitere SchoolKokohuia SchoolKowhai SchoolKristin SchoolKuranui CollegeLake Taupo Christian SchoolLawrence Area SchoolLevin Teen Parent UnitLincoln High SchoolLindisfarne CollegeLinwood CollegeListon CollegeLiving Way Learning CentreLogan Park High SchoolLong Bay CollegeLongburn Adventist CollegeLynfield CollegeLytton High SchoolMackenzie CollegeMacleans CollegeMahinawa Specialist School and ResourceMahurangi CollegeMairehau High SchoolMaitai SchoolMakoura CollegeMana CollegeMana TamarikiManaia School (Thames)Manawatu CollegeMangakahia Area SchoolMangakino Area SchoolMangakino High SchoolMangere CollegeManiapoto SchoolManiototo Area SchoolManukau Christian SchoolManukuraManurewa High SchoolMarcellin CollegeMarian CollegeMarist CollegeMarist College (Invercargill)Marlborough Boys' CollegeMarlborough Girls' CollegeMarsden Christian SchoolMarsden Christian SchoolMaru School & Resource CentreMassey High SchoolMatamata CollegeMataora Girls' Home SchoolMatarawa Special SchoolMcAuley High SchoolMcKenzie Residential SchoolMcKillop CollegeMelville High SchoolMenzies CollegeMercury Bay Area SchoolMercy CollegeMerton Street SchoolMichael Park SchoolMiddle School West AucklandMiddlemore Hospital SchoolMiddleton Grange SchoolMindAliveMission Heights Junior CollegeMoerewa SchoolMontessori College of Auckland (Closed)Moreau CollegeMorrinsville CollegeMosgiel IntermediateMotueka High SchoolMount Hutt CollegeMountainview High SchoolMt Albert Grammar SchoolMt Anglem CollegeMt Aspiring CollegeMt Hobson Middle SchoolMt Maunganui CollegeMt Richmond SchoolMt Roskill GrammarMurchison Area SchoolMurihiku Young Parents Learning CentreMurupara Area SchoolNaenae CollegeNapier Boys' High SchoolNapier Girls' High SchoolNayland CollegeNelson Christian AcademyNelson CollegeNelson College For GirlsNelson Teen Parent UnitNever Attended A Secondary SchoolNew Plymouth Boys' High SchoolNew Plymouth Girls' High SchoolNewlands CollegeNga Kakano Christian Bilingual SchoolNga Kakano Christian Reo Rua KuraNga Purapura o te ArohaNga Taiatea WharekuraNga Tawa Diocesan SchoolNgaruawahia High SchoolNgata Memorial CollegeNorthcote CollegeNorthern Health SchoolNorthern Southland CollegeNorthland CollegeNorthland College Teen Parent UnitNorthland Health Camp SchoolOaklynn Special SchoolOdyssey House School (Auckland)Odyssey House School (Christchurch)Okaihau CollegeOkato CollegeOne Tree Hill CollegeOnehunga High SchoolOnewhero Area SchoolOnslow CollegeOpihi CollegeOpononi Area SchoolOpotiki CollegeOpunake High SchoolOrewa CollegeOrmiston Junior CollegeOrmiston Senior CollegeOtago Boys' High SchoolOtago Girls' High SchoolOtahuhu CollegeOtaki CollegeOtaki Health Camp SchoolOtamatea Christian SchoolOtamatea High SchoolOtorohanga CollegeOtumoetai CollegeOverseas Secondary SchoolOxford Area SchoolPa Harakeke Teen Parent UnitPacific Advance Senior SchoolPaeroa CollegePakuranga CollegePakuranga Health Camp SchoolPalmerston North Boys' High SchoolPalmerston North Girls' High SchoolPanguru High SchoolPapakura High SchoolPapamoa CollegePapanui High SchoolPapatoetoe High SchoolParaparaumu CollegeParkside SchoolParkway CollegePatea Area SchoolPatricia Avenue SchoolPeace ExperimentPetone CollegePinehurst SchoolPinehurst Secondary SchoolPiopio CollegePleasant Point High SchoolPompallier Catholic CollegePonatahi Christian SchoolPonatahi Christian SchoolPorirua CollegeProspect CollegePukekohe Christian SchoolPukekohe Christian School (Secondary)Pukekohe High SchoolPukeora Home School (Phys.H'capped)Putaruru CollegePutaruru High SchoolQueen Charlotte CollegeQueen Elizabeth CollegeQueen Margaret CollegeQueen Victoria SchoolQueens CollegeQueens High SchoolRaglan Area SchoolRai Valley Area SchoolRangi Ruru Girls' SchoolRangiora High SchoolRangiora New Life SchoolRangitahi CollegeRangitaiki Independent SchoolRangitaiki Independent School (Sec Dept)Rangitikei CollegeRangitoto CollegeRaphael House Rudolf Steiner Area SchoolRathkeale CollegeRaukawa SchoolRaumanga SchoolRedwood CollegeReefton Area SchoolReefton SchoolReikorangi CollegeReporoa CollegeRiccarton High SchoolRichmond Christian CollegeRichmond View Secondary SchoolRodney CollegeRolleston CollegeRoncalli CollegeRongotai CollegeRosehill CollegeRosehill SchoolRoselyn SchoolRosmini CollegeRotorua Bible Baptist Church SchoolRotorua Boys' High SchoolRotorua Girls' High SchoolRotorua Lakes High SchoolRotorua School for Young ParentsRototuna Junior High SchoolRototuna Senior High SchoolRoxburgh Area SchoolRuapehu CollegeRuatoki Kura Tuarua SchoolRuawai CollegeRudolf Steiner School (Belmont)Rudolf Steiner School (Chch)Ruru Special SchoolRutherford CollegeSacred Heart College (Auckland)Sacred Heart College (Lower Hutt)Sacred Heart College (Napier)Sacred Heart College (Wanganui)Sacred Heart Girls' College (Chch)Sacred Heart Girls' College (Ham)Sacred Heart Girls' College (N Plymouth)Salisbury School (Nelson)Samuel Marsden Collegiate SchoolSamuel Marsden Collegiate School -WhitbySancta Maria CollegeSara Cohen SchoolScots CollegeSecondary School Not KnownSelwyn CollegeSeven Oaks Secondary SchoolShiloh Christian Academy (Motueka)Shirley Boys' High SchoolSilverstream Christian SchoolSilverstream Christian School SecondarySir Edmund Hillary Collegiate Senior SchSir Keith Park SchoolSolway CollegeSommerville SchoolSonrise Christian SchoolSouth Auckland Middle SchoolSouth Otago High SchoolSouth Westland Area SchoolSouthbridge District High SchoolSouthern Cross CampusSouthern Cross Middle SchoolSouthern Lakes Christian SchoolSouthern Lakes Christian School (Sec)Southern Regional Health SchoolSouthland Boys' High SchoolSouthland Girls' High SchoolSpotswood CollegeSpringbank SchoolSt Andrew's Christian School (Secondary)St Andrew's College (Christchurch)St Andrew's Middle School (Hamilton)St Bedes CollegeSt Benedicts CollegeSt Bernard's CollegeSt Catherines College (Invercargill)St Catherines College (Kilbirnie)St Cuthbert's College (Epsom)St Dominic's CollegeSt Dominic's College (Henderson)St Hildas CollegiateSt John's College (Hastings)St John's College (Hillcrest)St Joseph's Maori Girls' CollegeSt Kentigern College (Pakuranga)St Kentigern School for Girls - CorranSt Kevins College (Oamaru)St Margaret's CollegeSt Mark's Church SchoolSt Mark's Church School (Sec Dept) (Mt VSt Martin's Christian Secondary SchoolSt Mary's College (Chch)St Mary's College (Greymouth)St Mary's College (Ponsonby)St Mary's College (Wellington)St Mary's Diocesan School (Stratford)St Matthew's Collegiate (Masterton)St Oran's CollegeSt Patrick's College (Kilbirnie)St Patrick's College (Silverstream)St Patrick's College (Timaru)St Paul's College (Ponsonby)St Paul's Collegiate (Hamilton)St Peter's College (Epsom)St Peter's College (Gore)St Peter's College (Palmerston North)St Peter's School (Cambridge)St Raphaels School (Carterton)St Stephen's School (Bombay)St Thomas Girls High SchoolSt Thomas of Canterbury CollegeSt.Dominic's School For DeafSt.Paul's High School (Dunedin)Stratford High SchoolStratford High School Teen Parent UnitStrathallan CollegeSunnydene Special SchoolSunset Junior High SchoolTai WanangaTaieri CollegeTaihape Area SchoolTaihape CollegeTaikura Rudolf Steiner SchoolTaipa Area SchoolTaita CollegeTakapuna Grammar SchoolTamaki CollegeTamariki Special SchoolTamatea High SchoolTangaroa CollegeTangaroa College Teen Parent UnitTapawera Area SchoolTaradale High SchoolTararua CollegeTarawera High SchoolTau Te Arohanoa AkorangaTauhara CollegeTaumarunui Christian AcademyTaumarunui High SchoolTaupo-nui-a-Tia CollegeTauranga Boys' CollegeTauranga Girls' CollegeTauraroa Area SchoolTawa CollegeTe Aho o Te Kura PounamuTe Aratika AcademyTe Aroha CollegeTe Aute CollegeTe Awamutu CollegeTe Hiranui Special SchoolTe Kainga Whaiora Children's Health CampTe Karaka Area SchoolTe Kauwhata CollegeTe KKM o Puau Te Moananui-a-KiwaTe Kopuku HighTe Kuiti High SchoolTe Kura HauoraTe Kura Hourua o Whangarei Terenga ParaoTe Kura Kaupapa Maori o Horouta WanangaTe Kura Kaupapa Maori O Mana TamarikiTe Kura Kaupapa Maori o Ngati Kahungunu Ki HeretaungaTe Kura Mana Maori o WhangaparaoaTe Kura Maori o Nga TapuwaeTe Kura Maori o Nga TapuwaeTe Kura Maori o PoriruaTe Kura Maori-a-Rohe o WaiohauTe Kura O AwaruaTe Kura o HirangiTe Kura o Nga Ruahine RangiTe Kura o Te Whanau-a-ApanuiTe Kura Taumata O PanguruTe Kura Toitu o Te Whaiti-nui-a-ToiTe Kura-a-iwi o Whakatupuranga Rua ManoTe Pa o RakaihautuTe Piipiinga Kakano Mai RangiateaTe Puke High SchoolTe Rangi AniwaniwaTe Rangihakaka Centre for Science and TechnologyTe Tipu Whenua o Pa HarakekeTe Waha O Rerekohu Area SchoolTe Waha-O-Rerekohu Area SchoolTe Whakatipuranga (Otumoetai TPU)Te Whanau O TupurangaTe Whanau-A-Apanui Area SchoolTe Whare Whai Hua Teenage Parent CentreTe Wharekura O ArowhenuaTe Wharekura o ManiapotoTe Wharekura o ManurewaTe Wharekura o MauaoTe Wharekura O RakaumangamangaTe Wharekura O RuatokiTe Wharekura o Te Kaokaoroa o PatetereTe Wharekura o Te Rau ArohaTe Whata Tau o PutauakiTenison CollegeThames High SchoolThe Bridge AcademyThe Catlins Area SchoolThe Corelli SchoolThe Corelli School (Secondary)The Deep Green Bush SchoolThe Taieri High SchoolThurston Place CollegeTikipunga High SchoolTimaru Boys' High SchoolTimaru Christian SchoolTimaru Girls' High SchoolTitirangi Rudolf Steiner High SchoolTitirangi Rudolf Steiner SchoolTitiro WhakamuaTKK Motuhake o TawhiuauTKK o Te Wananga Whare Tapere o TakitimuTKKM o Hoani WaititiTKKM o HuiarauTKKM o KaikoheTKKM o Kawakawa mai TawhitiTkkm O Mana Tamariki (Secondary)TKKM o MangereTKKM o Nga MaungarongoTKKM o Nga MokopunaTKKM o Nga Uri A MauiTKKM o Nga Waipupu o PunahauTKKM O Ngati Kahungunu Ki HeretaungaTKKM o Ngati Kahungunu o Te WairoaTKKM o PukemiroTKKM o RuamataTKKM o Tamaki Nui A RuaTKKM o TaumarereTKKM O Te Ara HouTKKM o Te Ara WhanuiTKKM o Te KoutuTKKM o Te Kura KokiriTKKM o Te Raki PaewhenuaTKKM o Te Rawhiti RoaTKKM o Te RitoTKKM o Te Tonga o HokiangaTKKM O Te Waiu O Ngati PorouTKKM o Te Whanau TahiTKKM o Tuia te MatangiTKKM o TupohoTKKM o WairarapaTKKM o WaitahaTKKM o Whakarewa I Te Reo Ki TuwharetoaTKKM o WhangaroaTKKM Te Ahureinga o WhakatoheaTokanui Special SchoolTokomairiro High SchoolTokoroa High SchoolTolaga Bay Area SchoolTongariro High SchoolTongariro SchoolTotara College Of Accelerated LearningTotara College of Accelerated LearningTrident High SchoolTu ToaTuakau CollegeTurakina Maori Girls' CollegeTuranga Tangata RiteTweedsmuir Junior High SchoolTwizel Area SchoolTwizel High SchoolTyndale Park Christian SchoolUnlimited - Discovery Merged SchoolUnlimited Paenga TawhitiUpper Hutt CollegeUpper Valley Middle SchoolVan Asch Deaf Education CentreVanguard Military SchoolVanguard Military School ChristchurchVerdon CollegeVictory Christian AcademyVilla Maria CollegeWa Ora Montessori SchoolWaatea HighWaiau Area SchoolWaiheke Area SchoolWaiheke High SchoolWaihi CollegeWaikato Diocesan School For GirlsWaikato Waldorf School (Rudolf Steiner)Waikohu CollegeWaimate High SchoolWaimate North Christian SchoolWaimea CollegeWaimokoia Residential SchoolWainuiomata CollegeWainuiomata High SchoolWaiopehu CollegeWairarapa CollegeWairarapa Teen Parent UnitWairau Valley SchoolWairoa CollegeWaitaha SchoolWaitakere CollegeWaitaki Boys' High SchoolWaitaki Girls' High SchoolWaitara High SchoolWaiuku CollegeWaka Ora Boys' Home SchoolWakatipu High Frankton FlatsWakatipu High SchoolWanaka Area SchoolWanganui City CollegeWanganui Collegiate SchoolWanganui Girls' CollegeWanganui High SchoolWa-Ora SchoolWarea SchoolWaverley High SchoolWellington CollegeWellington East Girls' CollegeWellington Girls' CollegeWellington High School & Com Ed CentreWentworth CollegeWeraroa Hospital SchoolWesley CollegeWesleydale Boys' HomeWest City Christian CollegeWestbridge Residential SchoolWestern City Christian SchoolWestern Heights High SchoolWestern Springs CollegeWestlake Boys' High SchoolWestlake Girls' High SchoolWestland High SchoolWestminster Christian School (clsd)Westmount SchoolWeymouth Centre SchoolWhaiora SchoolWhakatane High SchoolWhakatane Teen Parent UnitWhakatipuria Teen Parent UnitWhangamata Area SchoolWhangaparaoa CollegeWhangarei Boys' High SchoolWhangarei Girls' High SchoolWhangaroa CollegeWharera Special School GroupWilliam Colenso CollegeWilson SchoolWindermere Christian CollegeWoodford HouseXavier CollegeZayed College for GirlsLast Year at Secondary School (YYYY - e.g. 2018)* Highest Secondary Qualification*No formal secondary school qualification14 or more credits at any levelNCEA Level 1 or School CertificateNCEA Level 2 or 6th Form CertificateUniversity EntranceNCEA Level 3 or Bursary or ScholarshipOverseas qualification (includes International Baccalaureate & Cambridge Exams)OtherNot knownFirst Year of Formal Education (YYYY - e.g. 2019) What qualification were you awarded?No qualification completedCertificate Level 1-3Certificate Level 4-5Diploma LevelBachelors DegreeMastersDoctorateOtherAre you eligible for Fees-free?*Fees-free eligibleNot Fees-free eligibleUnknownWhat was your main activity prior to study?*Secondary School StudentNon-employed or Beneficiary (excluding retired)Wage or Salary WorkerSelf-employedUniversity StudentPolytechnic StudentCollege of Education StudentHouse of Person or RetiredOverseas (irrespective of occupation)Private Training Establishment StudentWananga StudentLanguageWhat is your first language?* NationalitySee further information in our Terms and Conditions Documentation section at the end of this form. Citizenship (Country)* Residential Status* NZ or Australian Citizen (Not a Permanent Resident) Permanent Resident (Excludes NZ & Australian Citizens) Ethnicity*MāoriNZ EuropeanBritish/IrishDutchGreekPolishSouth SlavItalianGermanAustralianOther EuropeanSamoanCook Island MaoriTonganNiueanTokelauanFijianOther Pacific Island GroupsFilipinoCambodianVietnameseOther Southeast AsianChineseIndianSri LankanJapaneseKoreanOther AsianMiddle EasternLatin AmericanAfricanOtherNot StatedEthnicity 2MāoriNZ European/PakehaBritish/IrishDutchGreekPolishSouth SlavItalianGermanAustralianOther EuropeanSamoanCook Island MaoriTonganNiueanTokelauanFijianOther Pacific Island GroupsFilipinoCambodianVietnameseOther Southeast AsianChineseIndianSri LankanJapaneseKoreanOther AsianMiddle EasternLatin AmericanAfricanOtherNot StatedEthnicity 3MāoriNZ European/PakehaBritish/IrishDutchGreekPolishSouth SlavItalianGermanAustralianOther EuropeanSamoanCook Island MaoriTonganNiueanTokelauanFijianOther Pacific Island GroupsFilipinoCambodianVietnameseOther Southeast AsianChineseIndianSri LankanJapaneseKoreanOther AsianMiddle EasternLatin AmericanAfricanOtherNot StatedIwi AffliationHapu Affiliated to More Than One IwiHauraki Region, Iwi not namedKati MamoeManawatu/Horowhenua/Te Whanganui-a-TaraMaungaharuru TangituMorioriMuaupokoNga Potiki a TamapahoreNga RauruNga RuahineNgai Tahu / Kai TahuNgai Tai (Tauranga Moana/Mataatua)Ngai Tai, region not knownNgai Taki ki TamakiNgai TakotoNgai TamanuhiriNgai Te RangiNgapuhiNgapuhi ki Whaingaroa-Ngati Kahu ki WhaingaroaNgati Apa (Rangitikei)Ngati Apa ki Te Ra ToNgati AwaNgati HakoNgati Haua (Taumarunui)Ngati Haua (Waikato)Ngati Haua, region not knownNgati HauitiNgati HeiNgati HikairoNgati hine (Te Tai Tokerau)Ngati HineuruNgati KahuNgati Kahungunu ki HeretaungaNgati Kahungunu ki Tamakinui a RuaNgati Kahungunu ki TamateaNgati Kahungunu ki Te WairoaNgati Kahungunu ki Te Whanganui-a-OrotuNgati Kahungunu ki WairarapaNgati Kahungunu, region not knownNgati KauwhataNgati Kearoa / Ngati TuaraNgati KoataNgati Koroki KahukuraNgati KuiaNgati KuriNgati MakinoNgati ManawaNgati ManiapotoNgati ManuhiriNgati Maru (Hauraki)Ngati Maru (Taranaki)Ngati Maru, region not knownNgati Mutunga (Taranaki)Ngati Mutunga (Wharekauri/Chatham Islands)Ngati PahauweraNgati PaoaNgati Pikiao (Te Arawa)Ngati PorouNgati Porou ki Harataunga ki MataoraNgati PukengaNgati Pukenga ki WaiauNgati Rahiri TumutumuNgati RakaipaakaNgati Rangi (Ruapehu, Whanganui)Ngati RanginuiNgati Rangiteaorere (Te Arawa)Ngati Rangitihi (Te Arawa)Ngati Rangiwewehi (Te Arawa)Ngati RaruaNgati Raukawa (Horowhenua/Manawatu)Ngati RehuaNgati Rongomai (Te Arawa)Ngati RuanuiNgati Ruapani ki WaikaremoanaNgati Tahu-Ngati Whaoa (Te Arawa)Ngati Tama (Taranaki)Ngati Tama (Te Waipounamu/South Island)Ngati Tama ki Te Upoko o Te Ika (Te Whanganui-a-Tara/Wellington)Ngati Tama, region not knownNgati Tamakopiri (Rangitikei)Ngati TamaohoNgati TamateraNgati Tara TokanuiNgati Tarawhai (Te Arawa)Ngati Te AtaNgati Te Ohuake (Rangitikei)Ngati TiipaNgati Toarangatira (Te Waipounamu/South Island)Ngati Toarangatira (Te Whanganui a Tara/Wellington)Ngati TukoreheNgati Tuwharetoa (Ki Taupo)Ngati Tuwharetoa ki KawerauNgati Tuwharetoa, region not knownNgati WaiNgati Whakaue (Te Arawa)Ngati WhanaungaNgati WhareNgati Whatua (not Orakei or Kaipara)Ngati Whatua o KaiparaNgati Whatua o OrakeiNgati Whitikaupeka (Rangitikei)Ngatokimatawhaotua, iwi not namedPakakohiPatukirikiriRangitane (Manawatu)Rangitane (Te Matau a Maui/Hawke's Bay/Wairarapa)Rangitane (Te Waipounamu/South Island)Rangitane o Tamaki nui a RuaRaukawa (Waikato)RereahuResponse outside scopeRongomaiwahine (Te Mahia)RongowhakaataTainui, iwi not namedTamahaki (Ruapehu, Waimarino)Tamakana (Ruapehu, Waimarino)TangahoeTapuika (Te Arawa)TaranakiTaranaki Region, Iwi not namedTauranga Moana, iwi not namedTe Aitanga a HautiTe Aitanga-a-MahakiTe Akitai-WaiohuaTe Ati Haunui-a-PaparangiTe Atiawa (Taranaki)Te Atiawa (Te Waipounamu/South Island)Te Atiawa (Te Whanganui a Tara/Wellington)Te Atiawa ki WhakarongotaiTe AupouriTe Hika o PapaumaTe Kawwerau a MakiTe PaatuTe RarawaTe RoroaTe UpokoreheTe Uri-o HauTe Whanau-a-ApanuiTuhoeTuhourangi (Te Arawa)Turanganui a Kiwa, iwi not namedUenuku (Ruapehu, Waimarino)Uenuku-Kopako (Te Arawa)WaikatoWaitaha (Te Arawa)Waitaha (Te Waipounamu/South Island)WhakatoheaIwi Affliation 2Hapu Affiliated to More Than One IwiHauraki Region, Iwi not namedKati MamoeManawatu/Horowhenua/Te Whanganui-a-TaraMaungaharuru TangituMorioriMuaupokoNga Potiki a TamapahoreNga RauruNga RuahineNgai Tahu / Kai TahuNgai Tai (Tauranga Moana/Mataatua)Ngai Tai, region not knownNgai Taki ki TamakiNgai TakotoNgai TamanuhiriNgai Te RangiNgapuhiNgapuhi ki Whaingaroa-Ngati Kahu ki WhaingaroaNgati Apa (Rangitikei)Ngati Apa ki Te Ra ToNgati AwaNgati HakoNgati Haua (Taumarunui)Ngati Haua (Waikato)Ngati Haua, region not knownNgati HauitiNgati HeiNgati HikairoNgati hine (Te Tai Tokerau)Ngati HineuruNgati KahuNgati Kahungunu ki HeretaungaNgati Kahungunu ki Tamakinui a RuaNgati Kahungunu ki TamateaNgati Kahungunu ki Te WairoaNgati Kahungunu ki Te Whanganui-a-OrotuNgati Kahungunu ki WairarapaNgati Kahungunu, region not knownNgati KauwhataNgati Kearoa / Ngati TuaraNgati KoataNgati Koroki KahukuraNgati KuiaNgati KuriNgati MakinoNgati ManawaNgati ManiapotoNgati ManuhiriNgati Maru (Hauraki)Ngati Maru (Taranaki)Ngati Maru, region not knownNgati Mutunga (Taranaki)Ngati Mutunga (Wharekauri/Chatham Islands)Ngati PahauweraNgati PaoaNgati Pikiao (Te Arawa)Ngati PorouNgati Porou ki Harataunga ki MataoraNgati PukengaNgati Pukenga ki WaiauNgati Rahiri TumutumuNgati RakaipaakaNgati Rangi (Ruapehu, Whanganui)Ngati RanginuiNgati Rangiteaorere (Te Arawa)Ngati Rangitihi (Te Arawa)Ngati Rangiwewehi (Te Arawa)Ngati RaruaNgati Raukawa (Horowhenua/Manawatu)Ngati RehuaNgati Rongomai (Te Arawa)Ngati RuanuiNgati Ruapani ki WaikaremoanaNgati Tahu-Ngati Whaoa (Te Arawa)Ngati Tama (Taranaki)Ngati Tama (Te Waipounamu/South Island)Ngati Tama ki Te Upoko o Te Ika (Te Whanganui-a-Tara/Wellington)Ngati Tama, region not knownNgati Tamakopiri (Rangitikei)Ngati TamaohoNgati TamateraNgati Tara TokanuiNgati Tarawhai (Te Arawa)Ngati Te AtaNgati Te Ohuake (Rangitikei)Ngati TiipaNgati Toarangatira (Te Waipounamu/South Island)Ngati Toarangatira (Te Whanganui a Tara/Wellington)Ngati TukoreheNgati Tuwharetoa (Ki Taupo)Ngati Tuwharetoa ki KawerauNgati Tuwharetoa, region not knownNgati WaiNgati Whakaue (Te Arawa)Ngati WhanaungaNgati WhareNgati Whatua (not Orakei or Kaipara)Ngati Whatua o KaiparaNgati Whatua o OrakeiNgati Whitikaupeka (Rangitikei)Ngatokimatawhaotua, iwi not namedPakakohiPatukirikiriRangitane (Manawatu)Rangitane (Te Matau a Maui/Hawke's Bay/Wairarapa)Rangitane (Te Waipounamu/South Island)Rangitane o Tamaki nui a RuaRaukawa (Waikato)RereahuResponse outside scopeRongomaiwahine (Te Mahia)RongowhakaataTainui, iwi not namedTamahaki (Ruapehu, Waimarino)Tamakana (Ruapehu, Waimarino)TangahoeTapuika (Te Arawa)TaranakiTaranaki Region, Iwi not namedTauranga Moana, iwi not namedTe Aitanga a HautiTe Aitanga-a-MahakiTe Akitai-WaiohuaTe Ati Haunui-a-PaparangiTe Atiawa (Taranaki)Te Atiawa (Te Waipounamu/South Island)Te Atiawa (Te Whanganui a Tara/Wellington)Te Atiawa ki WhakarongotaiTe AupouriTe Hika o PapaumaTe Kawwerau a MakiTe PaatuTe RarawaTe RoroaTe UpokoreheTe Uri-o HauTe Whanau-a-ApanuiTuhoeTuhourangi (Te Arawa)Turanganui a Kiwa, iwi not namedUenuku (Ruapehu, Waimarino)Uenuku-Kopako (Te Arawa)WaikatoWaitaha (Te Arawa)Waitaha (Te Waipounamu/South Island)WhakatoheaIwi Affliation 3Hapu Affiliated to More Than One IwiHauraki Region, Iwi not namedKati MamoeManawatu/Horowhenua/Te Whanganui-a-TaraMaungaharuru TangituMorioriMuaupokoNga Potiki a TamapahoreNga RauruNga RuahineNgai Tahu / Kai TahuNgai Tai (Tauranga Moana/Mataatua)Ngai Tai, region not knownNgai Taki ki TamakiNgai TakotoNgai TamanuhiriNgai Te RangiNgapuhiNgapuhi ki Whaingaroa-Ngati Kahu ki WhaingaroaNgati Apa (Rangitikei)Ngati Apa ki Te Ra ToNgati AwaNgati HakoNgati Haua (Taumarunui)Ngati Haua (Waikato)Ngati Haua, region not knownNgati HauitiNgati HeiNgati HikairoNgati hine (Te Tai Tokerau)Ngati HineuruNgati KahuNgati Kahungunu ki HeretaungaNgati Kahungunu ki Tamakinui a RuaNgati Kahungunu ki TamateaNgati Kahungunu ki Te WairoaNgati Kahungunu ki Te Whanganui-a-OrotuNgati Kahungunu ki WairarapaNgati Kahungunu, region not knownNgati KauwhataNgati Kearoa / Ngati TuaraNgati KoataNgati Koroki KahukuraNgati KuiaNgati KuriNgati MakinoNgati ManawaNgati ManiapotoNgati ManuhiriNgati Maru (Hauraki)Ngati Maru (Taranaki)Ngati Maru, region not knownNgati Mutunga (Taranaki)Ngati Mutunga (Wharekauri/Chatham Islands)Ngati PahauweraNgati PaoaNgati Pikiao (Te Arawa)Ngati PorouNgati Porou ki Harataunga ki MataoraNgati PukengaNgati Pukenga ki WaiauNgati Rahiri TumutumuNgati RakaipaakaNgati Rangi (Ruapehu, Whanganui)Ngati RanginuiNgati Rangiteaorere (Te Arawa)Ngati Rangitihi (Te Arawa)Ngati Rangiwewehi (Te Arawa)Ngati RaruaNgati Raukawa (Horowhenua/Manawatu)Ngati RehuaNgati Rongomai (Te Arawa)Ngati RuanuiNgati Ruapani ki WaikaremoanaNgati Tahu-Ngati Whaoa (Te Arawa)Ngati Tama (Taranaki)Ngati Tama (Te Waipounamu/South Island)Ngati Tama ki Te Upoko o Te Ika (Te Whanganui-a-Tara/Wellington)Ngati Tama, region not knownNgati Tamakopiri (Rangitikei)Ngati TamaohoNgati TamateraNgati Tara TokanuiNgati Tarawhai (Te Arawa)Ngati Te AtaNgati Te Ohuake (Rangitikei)Ngati TiipaNgati Toarangatira (Te Waipounamu/South Island)Ngati Toarangatira (Te Whanganui a Tara/Wellington)Ngati TukoreheNgati Tuwharetoa (Ki Taupo)Ngati Tuwharetoa ki KawerauNgati Tuwharetoa, region not knownNgati WaiNgati Whakaue (Te Arawa)Ngati WhanaungaNgati WhareNgati Whatua (not Orakei or Kaipara)Ngati Whatua o KaiparaNgati Whatua o OrakeiNgati Whitikaupeka (Rangitikei)Ngatokimatawhaotua, iwi not namedPakakohiPatukirikiriRangitane (Manawatu)Rangitane (Te Matau a Maui/Hawke's Bay/Wairarapa)Rangitane (Te Waipounamu/South Island)Rangitane o Tamaki nui a RuaRaukawa (Waikato)RereahuResponse outside scopeRongomaiwahine (Te Mahia)RongowhakaataTainui, iwi not namedTamahaki (Ruapehu, Waimarino)Tamakana (Ruapehu, Waimarino)TangahoeTapuika (Te Arawa)TaranakiTaranaki Region, Iwi not namedTauranga Moana, iwi not namedTe Aitanga a HautiTe Aitanga-a-MahakiTe Akitai-WaiohuaTe Ati Haunui-a-PaparangiTe Atiawa (Taranaki)Te Atiawa (Te Waipounamu/South Island)Te Atiawa (Te Whanganui a Tara/Wellington)Te Atiawa ki WhakarongotaiTe AupouriTe Hika o PapaumaTe Kawwerau a MakiTe PaatuTe RarawaTe RoroaTe UpokoreheTe Uri-o HauTe Whanau-a-ApanuiTuhoeTuhourangi (Te Arawa)Turanganui a Kiwa, iwi not namedUenuku (Ruapehu, Waimarino)Uenuku-Kopako (Te Arawa)WaikatoWaitaha (Te Arawa)Waitaha (Te Waipounamu/South Island)Whakatohea DisabilityI understand that the completion of this question is not compulsory and that any information I supply is confidential.* Yes Do you live with the effects of significant injury, long term illness, or disability?YesNoI prefer not to answer this question.If yes, how would you describe your disability?Hearing/DeafPhysical/MobilityIntellectualLearningMental IllnessAcquired Brain ImpairmentVisionMedical ConditionOtherUnspecifiedINTERNATIONAL STUDENTS ONLYPassport Number Passport Expiry Date (DD/MM/YYYY) Passport CountrySelectAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoMyanmar (Burma)BurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileColombiaComorosCongo, Democratic Republic ofCongo, People's Republic ofCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaMicronesia, Federated States ofFijiFinlandMacedonia, The Former Yugoslav Republic ofFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, Republic of (South)KuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarMoldova, Republic ofRomaniaRussian FederationRwandaSamoaSan MarinoSao Tomé and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt Kitts and NevisSt LuciaSt Vincent and the GrenadinesSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaYemenZambiaZimbabweSouth SudanTimor-LesteChinaUnited KingdomVisa Number Visa TypeConsularDiplomaticLimitedMilitaryOfficialPermanent ResidentResidentReturning ResidentsStudentTransitVisitorWorkInterimVisa Expiry Date (DD/MM/YYYY) DD slash MM slash YYYY NationalitySelectAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoMyanmar (Burma)BurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileColombiaComorosCongo, Democratic Republic ofCongo, People's Republic ofCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaMicronesia, Federated States ofFijiFinlandMacedonia, The Former Yugoslav Republic ofFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, Republic of (South)KuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarMoldova, Republic ofRomaniaRussian FederationRwandaSamoaSan MarinoSao Tomé and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt Kitts and NevisSt LuciaSt Vincent and the GrenadinesSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaYemenZambiaZimbabweSouth SudanTimor-LesteChinaUnited KingdomOverseas AddressStreet Number Street Name Suburb Town City/Region Postcode CountrySelectAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoMyanmar (Burma)BurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileColombiaComorosCongo, Democratic Republic ofCongo, People's Republic ofCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaMicronesia, Federated States ofFijiFinlandMacedonia, The Former Yugoslav Republic ofFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, Republic of (South)KuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarMoldova, Republic ofRomaniaRussian FederationRwandaSamoaSan MarinoSao Tomé and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt Kitts and NevisSt LuciaSt Vincent and the GrenadinesSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaYemenZambiaZimbabweSouth SudanTimor-LesteChinaUnited Kingdom NEXT OF KINRelationship*PartnerSpouseParentSiblingGrandparentPartnerFriendOtherFirst Name* Last Name* Phone or Mobile Number* Email* QUALIFICATION ENROLMENTSelect one of the following:* NZ Certificate in Study & Career Preparation - Online only Bachelor of Natural Medicine (Limited courses available in Semester Two 2022) Certificate of Personal Interest (Limited courses available in Semester Two 2022) Where will you study?*In NZOverseasAre you applying to study full-time or part-time?*Please note: the NZ Certificate in Study & Career Preparation is only available full-time. Full-timePart-timeWould you like to study on-line or on-campus?*Please note: the NZ Certificate in Study & Career Preparation is online only. (International students must study at our Ellerslie campus.)On-lineOn-campusAre you applying for Recognised Prior Learning or Credit Recognition Transfer (RPL/CRT)*?This option applies to Bachelor of Natural Medicine applicants only. NZ CERTIFICATE IN STUDY & CAREER PREPARATIONAll students enrolled in the NZ Certificate of Study & Career Preparation take the same courses. No course enrolment is necessary. Please go directly to the Declaration section below.BACHELOR OF NATURAL MEDICINE COURSE ENROLMENTDo not select from the Certificate of Personal Interest courses below. Course selection will be discussed at your interview. Please go directly to the Declaration section below. PERSONAL INTEREST COURSE ENROLMENTPlease indicate the Certificate of Personal Interest course you are interested in studying. Please note that very limited places are available.Semester Two Courses 2022 CPI512 Anatomy & Physiology 2 CPI521 Biochemistry of Foods CPI532 Herbal Medicine 2 CPI542 Foundations of Research CPI643 Rongoā Māori Healing Concepts Additional CommentsDECLARATIONI have read the Terms and Conditions I declare that, to the best of my knowledge, all the information supplied in and with, this enrolment form is true and complete.* Yes I agree to abide by the conditions described above.* Yes I consent to the disclosure of personal information as described above.* Yes Signature (Type Name)* Today's Date (DD/MM/YYYY)* Thank you for completing your application form. Please remember to email your supporting documentation to Enrolment and Student Progression - ilaisaane.tuakalau@spcnm.ac.nz as soon as possible.NameThis field is for validation purposes and should be left unchanged.