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Please read the instructions below carefully before you complete this enrolment form.

INSTRUCTIONS

The purpose of this enrolment form is to obtain from you the information we need to enrol you into a qualification at our organisation. We also need to collect information from you which is required by the Ministry of Education and other Government agencies for statistical and registration reasons. Please fill in the form properly by:

  • Completing all sections of the form.
  • Printing your answers clearly in pen, or by ticking the box that applies for multi-choice questions.
  • Signing the form.

Attaching to the form additional documentation that is required for Ministry of Education funding purposes. A description of the required documentation is provided on page 5 of the form.

Please complete the form, then click "Submit".

Framework Solutions Ltd Enrolment Form 2010

QUALIFICATION
1
Please select the qualification you wish to enrol in for 2010:

Qualification Start Date:
Day Month Year
Qualification End Date:
(if known)
Day Month Year
2
Please select the names(s) of the courses you wish to enrol in for 2010: (7091/7115/19444) Establish a culturally safe and inclusive learning environment for adults in New Zealand's cultural setting
(4098/11281) Assessor Training
(7103/7093) TNA and Instructional Design
(7097/7114) Training Delivery
(11551/11552) Design Assessment and Moderate Assessment
3
Have you studied at Framework Solutions Ltd before?
Yes   No  
If you answered "yes", what was your ID number?
4
Do you intend to study:
Part-time   Full-time  
PERSONAL DETAILS
5
Print your full legal name: Family Name:
Given Name(s):
6
Preferred first name:
Previous name(s) known by:
7
If you have previously enrolled at this organisation under another name, what was that name?
8
Preferred title: Other (Specify):
9
Date of birth:
Day Month Year
Gender:
Male   Female  
10
If you know your NSN (National Student Number), please write it here:
11
Citizenship and Residency:
You may need to supply evidence of residence or citizenship		 Tick the box which best describes your citizenship or permanent residency status.
New Zealand Citizen NZL
Australian Citizen AUS
New Zealand Permanent Resident NZP
Other
Please specify if "Other":
(For students with dual citizenship, specify the country of citizenship of the passport used to enter New Zealand.)
If you ticked "Other", please also specify your fee/assistance status.
NZAID Scholarship
(incl. Aotearoa; short-term training; and post-graduate)		 01
Full Fee Paying Foreign Student 03
Exchange Scheme approved by Ministry of Education 04
Foreign Research Based Post-Graduate 06
Military Personnel; Diplomatic Staff or Family;
or Persons Associated with Operation Deep Freeze		 08
During your time studying in this qualification will you be resident in New Zealand or overseas?
In New Zealand   Overseas  
12
Ethnicity: What ethnic group(s) do you belong to?
You may tick up to three boxes, which apply to you.
NZ European/Pakeha 111
New Zealand Māori 211
Samoan 311
Cook Island Māori 321
Tongan 331
Niue 341
Tokelauen 351
Fijian 361
Other Pacific Peoples 371
British/Irish 121
Dutch 122
Greek 123
Polish 124
South Slav 125
Italian 126
German 127
Australian 128
Other European 129
Filipino 411
Cambodian 412
Vietnamese 413
Other Southeast Asian 414
Chinese 421
Indian 431
Sri Lankan 441
Japanese 442
Korean 443
Other Asian 444
Middle Eastern 511
Latin American 521
African 531
Other 611
Not Stated 999
Please specify if "Other Pacific Peoples", "Other European", "Other Southeast Asian", "Other Asian" or "Other".
13
Iwi: If you identified as New Zealand Māori in question 12, what is the name of your Iwi?
You may enter more than one Iwi. If you do not know your Iwi, please enter 'Don't Know'.		 Iwi:
Rohe (Iwi home area):
Iwi:
Rohe (Iwi home area):
Iwi:
Rohe (Iwi home area):
14
Prior activity: What was your MAIN activity or occupation in New Zealand at 1 October 2007?
You may tick only one box.
Secondary school student 01
Non-employed or beneficiary (excluding retired) 02
Wage or salary worker 03
Self-employed 04
University student 05
Polytechnic student 06
College of Education student 07
House-person or retired 08
Overseas (irrespective of occupation) 09
Private Training Establishment student 11
Wānanga student 12
15
Disability: Do you live with the effects of significant injury, long term illness, or disability?
The information you supply is confidential.
Yes   No  
If yes, how would you describe your impairment, disability or long term medical condition:
ACADEMIC INFORMATION
16
Secondary School: What was the name of the last secondary school you attended?
State "overseas", if applicable.
What was your last year at secondary school?
What is the highest level of achievement you hold from a secondary school?
Your highest achievement may be a "traditional" award such as School Certificate, or you may have achieved a number of credits or a National Certificate at a certain level on the National Qualifications Framework. Your NZQA Record of Learning shows you how many credits you have. Tick only one box.
No formal secondary qualifications 00
14 or more credits at any level 11
NCEA Level 1 or School Certificate 12
NCEA Level 2 or 6th Form Certificate 13
University Entrance 14
NCEA Level 3 or Bursary or Scholarship 15
Overseas qualification
(includes International Baccalaureate & Cambridge Exams)		 09
Other 98
Not Known 99
Please specify if "Overseas qualification" or "Other".
17
Tertiary Study: Will this be the first year you have ever enrolled in a University, Polytechnic, College of Education, Private Training Establishment, or Wānanga either in New Zealand or overseas since leaving school?
Do not include enrolments in STAR, community or hobby classes.
Yes   No  
If you answered "No", please enter the name of the organisation you studied at and the year of your first enrolment:
Name:
Year:
Do you expect to complete the academic requirements of your course/s in order to graduate with your qualification this year?
Yes   No  
DOCUMENTATION
18

To qualify as a domestic student, and so be entitled to the Government tuition subsidy, you must be a citizen of New Zealand (including students from the Cook Islands, Tokelau, or Niue who have New Zealand citizenship) or a permanent resident of New Zealand or a citizen or permanent resident of Australia residing in New Zealand. You must provide evidence of citizenship or permanent residency and to do so you must produce one of the following:

  • Birth certificate with place of birth stated as New Zealand, Cook Islands, Tokelau, or Niue.
  • New Zealand passport.
  • A statement of Whakapapa, including date of birth, countersigned by a kaumatua.
  • Certificate of citizenship or letter of confirmation.
  • Overseas passport with residency stamp.

You can bring the original documentation to the enrolment desk, alternatively please provide a certified copy. This means a photocopy of your original document, signed as being a true and accurate copy by a Justice of the Peace (JP), Solicitor, Minister of the Church, General Practitioner or School Principal for example.

International students must bring their passport with them when they enrol.

Please note that your name, date of birth and residency as entered on this enrolment will be included in the National Student Index, and will be used in an Authorised Information Matching programme with the New Zealand Birth Register. For further information please see: http://www.nsi.govt.nz/ima.
19
Please list here all documents that you have attached to this enrolment form.
Documents should be securely stapled to the back of the form.
Please Note: On-line enrolments can bring this documentation with them on the day of their training.
CONTACT DETAILS
20
Address and contact details: Home Address: Postal Address:
(if different from home address)
Phone: Mobile:
Fax: Email:
Next of Kin: Name: Phone:
DECLARATION

Privacy - The Organisation collects and stores information from this form to comply with the requirements of the Ministry of Education (student statistical returns), New Zealand Qualifications Authority (Record of Learning registration and Unit Standard outcomes), Tertiary Education Commission (funding returns), Industry Training Organisations (funding and academic outcomes), Ministry of Social Development (confirmation of enrolment and academic outcomes), Inland Revenue Department (student loan interest rebate), Department of Immigration (if you are not a New Zealand citizen or permanent resident) and Agencies who support particular students through scholarships and prizes, payment of fees or other awards (if you are a recipient of one of these awards). The information is also used to select students for qualifications, to manage internal administrative processes, and for internal reporting. Information about students may be supplied to, and sought from, other educational organisations for the purpose of verifying academic records.

In addition, when required by statute, the Institute releases information to Government agencies such as the New Zealand Police, Department of Justice, Ministry of Social Development, and the Accident Compensation Corporation (ACC).

In signing this enrolment form you authorise such disclosure on the understanding that the Organisation will observe the general conditions governing the release of information, as set out in the Privacy Act 1993 and the Post-compulsory Unique Identifier Code of Practice. You may see any information held about you and amend any errors in that information. To do so, contact the Enrolments Officer.

NB: The Privacy Act came into force on 1 July 1993 with the stated aim of protecting the privacy of natural persons. It requires the Organisation to collect, hold, handle, use and disclose personal information in accordance with the twelve information privacy principles in the Act. http://www.privacy.org.nz/privacy-act/

Fees - In signing this enrolment form you undertake to pay all fees as they become due, and to meet any late fees and collection charges associated with debt recovery. The Organisation's policy on withdrawal and refund of fees may be obtained from the Enrolments Officer.

Rules - In signing this enrolment form you undertake to comply with the published rules and policies of the Organisation with regard to attendance, academic progress, standard of dress, health and safety, and behaviour.

Declaration - I declare that to the best of my knowledge all the information supplied on, and with, this enrolment form is true and complete, I agree to abide by the conditions described above, and I consent to the disclosure of personal information as described above.
__________________________________________
Signature		 _______/_______/_______
Date
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