Application For Enrolment International

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Application For Enrolment - International

Imperial College of New Zealand (Provider No. 7499)

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

INSTRUCTIONS

The purpose of this form is to obtain from you the information we need to assess you for admission into a course or qualification at Imperial.

Please fill in the form properly by:

  • Completing all sections of the form.
  • Printing your answers clearly, or by ticking the box that applies for multi-choice questions.
  • Reading the Student Handbook and then signing the form.
  • Attaching to the form additional documentation that we require from you.
Select Course(s) You Wish to Enrol In
Personal Details
Emergency Contact Details
English Proficiency
Accommodation / Health
Health and Insurance

You are required to have appropriate Travel/Medical Insurance for the duration of your course. You will be invoiced for this unless you can provide an English version of your own insurance.

If the answer is NO, please complete and attach the International Student Insurance Application Form.
If the answer is YES, please provide details of your medical condition and attach this to your application.
Education Agent Details

If you were referred by an education agent, provide the information below.

Student Declaration

I declare that to the best of my knowledge all the information supplied is true and complete. I agree to abide by the rules and policies of the organisation and consent to the disclosure of personal information as required.

Code of Practice

Imperial College of New Zealand has agreed to observe and be bound by The Education (Pastoral Care of Tertiary and International Learners) Code of Practice 2021 (the Code). Copies of the Code are available from the NZQA website.

Privacy

ICNZ collects and stores information from this form to comply with the requirements of and, where applicable:

  • 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)
  • Agencies who support students through scholarships, prizes, payment of fees, or other awards

The information is also used to select students for qualifications, manage internal administrative processes, and for internal reporting. Information about students may be supplied to, and sought from, other educational organisations for verifying academic records.

In addition, when required by statute, the College 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 by contacting the Admissions Officer.

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 Admissions 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.

Completed Application along with supporting documents can be mailed, emailed, or hand delivered to:

Admissions Team
Imperial College of New Zealand
Imperial House, Level 3, 16 Waverley St, Auckland City, New Zealand 1141
Tel: +64 9 377 1395
Email: admissions@imperial.ac.nz

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