Pathway Programme Application Form

NZSE College Pathway Programmes Application Form

This application form is intended to assist school staff and/or parents in enrolling students into NZSE College's Secondary School Pathways Programme. The information collected is required by the Ministry of Education and other government agencies for statistical and registration purposes. Some questions are mandatory and must be answered. NZSE College will process the enrollment form and notify the schools or send an email confirmation regarding the student's enrollment. If you need any assistance, please contact Margaret Moala at margaret@nzse.ac.nz or text her at 021 871 494.
Select your Programme / Course*

Student Information

Please note: If applicant is under 18 years of age, the application must be signed by the parent/guardian and all correspondence regarding your application will be forwarded to your education agent and/or to your parent/guardian.
Are you over 18 years of age?

YesNo
Student First Name(s):*
Student Middle Name(s):
Student Last Name:*
Student Preferred Name(s):
Your Date of Birth*

DayMonthYear
Date
Preferred Title
Gender*
NSN Number*
Name of School Attending*
Current year at secondary school?*

Student Contact Details
Email*
example@example.com
Mobile Phone*

Pre-FixPhone Number
Secondary Phone

Pre-FixPhone Number
Address
Mailing Address Line 1
Suburb
City
Postal/Zip Code
Country
Citizenship and Residency

To qualify as domestic student, you must be a New Zealand citizen (including students from the Cook Islands, Tokelau or Niue who have New Zealand citizenship) OR hold a resident visa, permanent resident of New Zealand OR a permanent resident of Australia residing in New Zealand.
Citizenship Status
Citizenship
Country of Birth
Ethnicity*
Second Ethnicity
Third Ethnicity
If you identified as New Zealand Māori, with which Iwi do you identify?*

Emergency Contact Details (Next of kin)

A staff member may contact the nominated emergency contact, in relation to the applicant’s wellbeing and safety.
Emergency Contact First Name*
Emergency Contact Last Name*
Relationship to Student*
Emergency Contact Mobile Number*

Area CodePhone Number
Emergency Contact Email
example@example.com
School Contact Details

An NZSE staff member may contact the nominated contact person listed below regarding the student's wellbeing and safety in the following situations: (a) if the student is absent from the programme without prior notice, (b) in the event of a medical emergency, or (c) if there are reasonable grounds to believe that disclosure is necessary to prevent or reduce a serious threat to the student's life or health.
First Name*
Last Name*
Name of School*
School Name*
Title/Role at School*
Contact Mobile Number*

Area CodePhone Number
Emergency Contact Email*
example@example.com

NZSE College Pathway Programmes Application Form