CPL Form 1 - Standard Enrolment Form

Contact Continued

Please provide us with your contact details
Your Address*

Street Address

Street Address Line 2

CityRegion

Post Code
Do you live with the effects of significant injury, long term illness, or disability?*

YesNo
Do you access a disability service?*
Please provide details about your injury, long term illness, or disability
Bank Account Holder
Bank Account Number
Drivers License Number

Study in New Zealand

The NZ Government wants to know a few more things about you
What is your Country of Birth?*
What is your Region of Birth?*
Region of Birth
What is your Country of Citizenship?*
What is your NZ residency status?*
Only NZ Citizens or NZ Residents living in New Zealand can be enrolled.
What is your current NZ visa?
NSN Number
This is the New Zealand Student Number
You can identify with up to three ethnicities, please select at least one below
Ethnicity 1*
Ethnicity 2
Ethnicity 3
If you have selected Maori at least once in above selection, you can affiliate with up to three IWI's
IWI 1*
IWI 2
IWI 3
What is your main activity prior to starting these studies?*
What is the name of the last secondary school you attended?
What was your last year at secondary school?
What is the highest qualification you hold from a secondary school?
When did you gain this qualification?
What is your highest post-school qualification?
Will your enrolment be the first year you have ever enrolled in tertiary studies?*

YesNo
Since you answered 'No' above, what was your first year?*

Standard enrolment Form