Enrolment Form | | Aspire2 Health & Wellbeing Online

Personal Details

Last Name / Tōu Ingoa Whakamutunga*

First Names / Tōu Ingoa Tuatahi*

Preferred first name / Tōu Ingoa hiahia ake

Previous names known by / Tōu Ingoa o mua

Preferred Title / Tōu taitara hiahia ake*

Date of birth / Tōu ra whanau*

Gender / Ira tangata*

Male

Female

Diverse

Home Address while studying / Wāhitau Kaainga i a koe e ako ana*

Address / Tōu Wāhitau Address Line 2 City / Te taone Post Code / Waehere Poutāpeta Country / Te whenua

Day Time Phone / Tōu waea I te ra*

Evening Phone / Tōu waea I te po

Mobile / Tōu waea pūkoro*

Email / Tōu Īmera*

Postal Address (if different from home address – cannot be a PO Box) / Wāhitau poutāpeta (mena ka rerekē ki tōu wāhitau. Kaore he PO Box tēna)

Address / Tōu Wāhitau Address Line 2 City / Te taone Post Code Country / Te whenua

Please Select your Qualification / Whiriwhiria tōu tohu

Please select your start date / Whiriwhiria tōu timatanga

Have you studied with us before?*

Yes

No

Do you intend to study... / Pehea tōu whiriwhiri ako...*

Full Time

Part Time

Have you applied for Recognition of Prior Learning? / I tono koe ki a matou ki te whakamihi nga akoranga o mua?*

Yes

No

How did you hear about us? / I pehea koe I ako ai mo matou?*

Other / Tetahi atu*

What is your reason for enrolling? / Pehea tōu take I whakauru?*

What is your intended career pathway?*

What is your intended study pathway?*

Please explain:*

How are you paying your fees?*

Visa Card

Mastercard

Student Loan

Online Banking

Fees Free

Do you require a student ID card? / Kei te hiahia koe he kaari ID akonga?*

Yes / Āe

No / Kaore

Student ID cards are optional – you don’t need one to study with us.

If you are unable to provide your ID or copies of your proof of entry criteria below, not to worry, you can still proceed with your application by clicking NEXT below.

We can support you in getting together your documents. Note any help you need here and our team can assist you.

Please attach verified ID here

Max. file size: 32 MB.

Please attach your Proof of Entry Criteria here

Max. file size: 32 MB.

Please provide proof of valid First Aid here (for Level 7 applicants only)

Max. file size: 32 MB.

If you have requested a student ID please attach head and shoulders photo here

Accepted file types: jpg, gif, png, pdf, Max. file size: 32 MB.

If you are not able to upload a photo now, email it to us at [email protected]

Next of Kin / Tōu whanaunga

Who would you like us to contact in the event of an emergency? (Please do not enter your own details.)

Name / Ratou Ingoa*

Include first name and surname

Phone / Ratou waea*

Privacy Information

Privacy – Aspire2 Health & Wellbeing collects and stores information from this form to:

manage the business of Aspire2 Health & Wellbeing (including internal reporting, administrative processes and selection of scholarship and prize winners)
comply with the requirements of the Education Act 2020 and other legislation relating to maintenance of records
supply information to government agencies and other organisations as set out below.

In submitting this enrollment form you authorise such disclosure on the understanding that Aspire2 Health & Wellbeing will observe the conditions governing the release of information, as set out in the Privacy Act 2020, the Education Act 2020 and other relevant legislation. 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 2020 with the stated aim of protecting the privacy of natural persons. It requires Aspire2 Health & Wellbeing to collect, hold, handle, use and disclose personal information in accordance with the 13 information privacy principles in the Act. https://www.privacy.org.nz/privacy-act-2020/privacy-act-2020/ Supply of information to government agencies and other organisations Aspire2 Health & Wellbeing supplies data collected on this form to government agencies, including:

the Ministry of Education
the New Zealand Qualifications Authority
the Tertiary Education Commission
the Ministry of Social Development (in relation to student loans and allowances) and Inland Revenue (student loans)
Immigration New Zealand and the Ministry of Business, Innovation and Employment (for those who are not New Zealand citizens or permanent residents)
agencies which support particular students through scholarships, payment of fees or other awards (if you are a recipient of one of these awards).

Those agencies use the data collected from tertiary education organisations to:

administer the tertiary education system, including allocating funding
develop policy advice for government
conduct statistical analysis and research.

Your personal details (name, date of birth and residency) as entered on this form will be included in the National Student Index and may be used in an authorised information matching programme with the New Zealand Birth Register. The government agencies above may supply data collected on this form to Statistics New Zealand for the purposes of integrating data with data collected by other government agencies, subject to the provisions of the Statistics Act 1975. Integrated data is used for the production of official statistics, to inform policy advice to government and for research purposes. In handling data supplied by you on this form, the government agencies are required to comply with the provisions of the Privacy Act 2020. When required by law, Aspire2 Health & Wellbeing releases information to government agencies such as the New Zealand Police, Department of Justice, Ministry of Social Development, and the Accident Compensation Corporation (ACC). Information collected on this form may be supplied to other educational organisations for the purpose of verifying academic records. 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. Aspire2 Health & Wellbeing’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 Aspire2 Health & Wellbeing with regard to attendance, academic integrity and progress, conduct and use of information systems.

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. By ticking the box I agree to the enrolment and wish to be sent an acknowledgement of my place in the programme.*

Yes

Click here to view the code of conduct.

Click here to view Aspire2 Health & Wellbeing terms and conditions.

Email

This field is for validation purposes and should be left unchanged.

Aspire2 Health & Wellbeing Enrolment Application Form

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Personal Details

Schooling

Citizenship Details

Health and Disability

Next of Kin / Tōu whanaunga

Privacy Information