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NZQA Registration Form

This 2-page NZQA registration form collects personal information such as name, address, date of birth, gender, and ethnic background. Applicants are asked to provide their NSN number if known, sign and date the form, and return it to their teaching institution or assessor. The information is collected for statistical purposes and to authorize NZQA to exchange enrollment information with the applicant's institution.

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AleksandarSashaStankovich
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238 views2 pages

NZQA Registration Form

This 2-page NZQA registration form collects personal information such as name, address, date of birth, gender, and ethnic background. Applicants are asked to provide their NSN number if known, sign and date the form, and return it to their teaching institution or assessor. The information is collected for statistical purposes and to authorize NZQA to exchange enrollment information with the applicant's institution.

Uploaded by

AleksandarSashaStankovich
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 2

NZQA USE ONLY

All sections of this form must be completed. Please print clearly.

NZQA Registration Form


Return this form to your teaching institution or your assessor.

NSN NUMBER:
(If Known)

Please note that the name entered in this section will appear on your Record of Achievement and certificates
Surname (family name)

First names (given names in full)

ADDRESS:
This should be your permanent address, NOT a temporary address used while attending a teaching institution .

Date Local (Providers) Student ID (if applicable)


of
Birth Day Month Year

Tick appropriate box (for statistical purposes only) Male Female

Tick box(es) next to the ethnic group(s) you feel you belong to (for statistical purposes only) (Maximum of
3 boxes)

NZ European/Pakeha Cook Island Māori Sri Lankan


British/Irish Tongan Japanese
Dutch Niuean Korean
Greek Tokelauan Other Asian
Polish Fijian Middle Eastern
South Slav Other Pacific Island group Latin American
Italian Filipino African
German Cambodian Other
Australian Vietnamese Not Stated
Other European Other Southeast Asian
New Zealand Māori Chinese
Samoan Indian

Page 1 of 2
New Zealand Qualifications Authority, PO Box 160, Wellington 6140 Telephone: 04 802 3000 Fax: 04 463 3107
Name of Teaching
Institution / ITO:

I declare that the particulars given above are correct and authorise the New Zealand Qualifications Authority
to collect information from, and/or exchange information with any Teaching Institution, Industry Training
Organisation or Government Agency with which I am enrolled, or have requested enrolment or funding.
Signed Date

Page 2 of 2
Post/Fax the completed form to: New Zealand Qualifications Authority, P O Box 160, Wellington 6140
Telephone:  04­802­3000 Fax:  04­463­3107

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