SPCNM Enrolment Application Form

Enrolment Application Form

Apply to enrol now
Please download and complete this Questionnaire before starting your online Enrolment Application. Ensure that you have all your supporting documents ready to upload before commencing your application.

By clicking the option "Start Application”, I, as the Applicant, hereby consent to the processing of my provided personal information for the purpose of application and enrolment in the programme selected below. Please see our terms and conditions.
Intakeid*
Progid*
You Have Selected Intake
You Have Selected Programme
Select your Programme / Course*
Total

Your Contact Details

Please provide us with your contact details
Title
What is your full, legal name?
Your First Name*
Your Middle Name/s
Your Surname*
Your Preferred First Name*
Previous Name/s Known By
Phone Number*

Pre-FixPhone Number
Email*
example@example.com
Your Date of Birth*

DayMonthYear
Date
Your Gender*
Take a photo for your Student ID (head and shoulder passport-style)
IRD number

Contact Continued

Please provide us with your contact details
Your Address*

Street Address

Street Address Line 2

CityRegion

Post Code
Your Mail Address (if different from your physical address, above)

Street Address

Street Address Line 2

CityRegion

Post Code

Additional Needs & Supports

Please provide us with details of your additional needs and supports that would help you
The information you provide is collected for statistical purposes and to help us understand our learners’ needs.
Do you describe yourself as disabled, deaf, neurodiverse, tangata whaikaha Māori, or living with a long-term physical or mental health condition?*

YesNoI prefer not to answer this question
If you answered ‘Yes’ to the question above, please provide further details.
Please provide details about your long term illness or medical condition/s

Emergency Contact

In case of an emergency, who shall we contact?
Emergency Contact Relationship*
Emergency Contact Name*

First NameLast Name
Phone Number*

Pre-FixPhone Number
Email*
example@example.com

Nationality & Prior Education

We are required to collect the following information for statistical purposes
What is your Country of Birth?*
What is your Country of Citizenship?*
What is your Residency status?*
What type is your current NZ visa?
What is your Visa number?
What is your Visa expiry date?

DayMonthYear
What is your passport number?
What is your passport expiry date?

DayMonthYear
NSN Number (if known)
This is the New Zealand Student Number
Please select at least one ethnic group you belong to. You may select up to three
Ethnicity 1*
Ethnicity 2
Ethnicity 3
If you have selected Māori in the above selection, please identify up to three iwi you affiliate with. If you do not know your iwi, please enter "Do not know the name of iwi".
IWI 1*
IWI 2
IWI 3
Is English your first language?

YesNo
If 'No', please submit proof of English proficiency at the end of this application
What is your main activity at this time?*
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?*
Please specify if "Overseas qualification" or "Other"
When did you gain this qualification?
Will this be your first time applying for tertiary studies?*

YesNo
Since you answered 'No' above, what was your first year?
If applicable, what is your highest tertiary qualification?*
Please submit proof of previous study (your official academic transcript and/or a copy of your NZQA record of achievement) with your supporting documents

Your Documents

Please upload your supporting documents
Please select identity document 1 – Certified Proof of Residency *
Upload your identity document 1 – Certified Proof of Residency*

Scan or take a photograph of your certified proof of residency – e.g. birth certificate or current passport showing your current legal name.
Cancelof
Please select identity document 2 – Certified Photo ID*
Upload your identity document 2 – Certified Photo ID*

Scan or take a photograph of your certified photo ID – e.g. current passport or drivers licence showing your current legal name. This will need to be a different document to your proof of residency document.
Cancelof
Please upload your Letter of Recommendation*

Scan or take a photograph of your certified photo ID – e.g. current passport or drivers licence showing your current legal name. This will need to be a different document to your proof of residency document.
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Please upload your completed Questionnaire & Study Time Plan*

Please upload your completed "Questionnaire & Study Time Plan - Please Tell Us About Yourself"
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Please upload any other required documents

If you have copies of your official academic transcript and/or a copy of your NZQA record of achievement from previous study, please upload here.
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Drivers License Number

Thank you

Please sign your application
How did you hear about us?
Math Challenge
Signature*

Clear
Date

DayMonthYear
Should be Empty:

Enrolment Application Form

Your Contact Details

Contact Continued

Additional Needs & Supports

Emergency Contact

Nationality & Prior Education

Your Documents

Thank you