NorthTec Application Form

Programme of Study

This application form is the first step along the path to enrolment. You will not be fully enrolled until:

You complete and submit this Application Form.
You have received formal written notification that your application has been successful.
You have returned the 'offer of place' acceptance document to confirm your place on your programme of study. You will receive this 'offer of place' with your formal notification.

Course Details

Email Address

Student Status

If you have New Zealand residency, citizenship or refugee status, or if you are from Australia, Niue, the Cook Islands, and Tokelau, you should follow the application process for NZ domestic students.

NZ Domestic StudentInternational Student

Study Preference(Optional)Full-timePart-time

Please note that some programmes may be full-time or part-time only.

Additional Information

If applicable, provide additional programme details not included above (e.g. "Part-time"; "AMIF603 - Introduction to Finance paper only"; "Accounting Major" etc.)

Personal Information

First Name(s)

Last Name

Preferred First Name

Previous Name(Optional)

Have you previously enrolled under another name, or are you known by another name?

Date of Birth

Day

Month

Year

GenderFemaleMaleAnother Gender

Phone (at least one required)

Mobile

Home

Postal Address

Number and Street

Suburb

Town/City

Post code

Will this be your address while studying?YesNo

Please select your country of citizenship

Country of birth

Ethnicity

What ethnic group(s) do you belong to? (Choose up to six)

Iwi

If you identified as New Zealand Maori, with which Iwi do you identify? You may enter more than one Iwi.

Proof of Identity

If this is the first time you have registered with NorthTec (or you have never supplied documents in the past) you need to provide a verified copy of evidence of your full legal name and age.

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Max file size 10MB.

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Acceptable documents include:

Birth Certificate, Passport or Certificate of Citizenship (with place of birth stated as New Zealand, Cook Islands, Tokelau, Niue, or Australia).
Overseas Passport with residency stamp, work permit or student permit for international students.
Certificate of Identity (from the New Zealand Immigration Service).
Marriage Certificate or Deed Poll declaration (for change of legal name only).
Statement of Whakapapa: A verified copy of a whakapapa statement is acceptable only when a birth certificate cannot be obtained. Both the learner and a kaumatua must sign the whakapapa as evidence of identity and citizenship.

Do you live with the effects of significant health injury, long-term illness or disability?(Optional)

This information is confidential to Te Pūkenga but it could be used by the Student Advisors to obtain further resources and support that will assist you in your studies.

Access to assistive technology (e.g. for reading, writing, communication).Accessible format resources for course content.Mobility and transport (e.g. navigator support to help movement around campus, mobility carparks, personal emergency evacuation plan).New Zealand Sign Language InterpreterSupport with reading, writing, and communicating in learning sessions, exams, and assessments.

Would you like to discuss your support needs or any specific requirements with our support team(Optional)YesNo

Student Declaration and Conditions

‍Privacy – All personal information that you provide on a Te Pūkenga website will be held exclusively by Te Pūkenga for the purposes set out in our Privacy Policy.

By providing your personal information, you are deemed to consent to your information being shared within Te Pūkenga, in order to ensure that Te Pūkenga is able to perform the functions that it is established to perform and best serve all staff and learners.

Fees – I agree to pay all fees as they become due, and to meet any late fees and collection charges associated with debt recovery.

Rules – I have read and agree to comply with the statutes, regulations, rules and policies of NorthTec.

Health and Safety – You undertake to disclose, prior to enrolment, all health information that might affect your ability to complete the programme or the health and safety of yourself or others. If you do not disclose all relevant information staff will be unable to advise you appropriately and you may enrol on a programme that you are unable to complete.

Educational Regulatory Framework – I have read and agree with the information in the document entitled “Notification Document: Guidance as to how Te Pūkenga will transition learners onto the new educational regulatory framework and terms and conditions of enrolment from 1 January 2023”

I declare that to the best of my knowledge all the information supplied on and with this Registration 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.

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