| Personal Information |
Family Name (Mr./Mrs./Miss/Ms)
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Given Name
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Address in Home Country
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City
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Country
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Nationality
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Address in New Zealand (if applicable)
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Date of Birth
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Email
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Phone
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Passport Number
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Gender
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Upload copy of passport
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| Emergency Contact Who is your nearest relative or guardian in New Zealand for contact in case of an emergency? |
Name
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Phone
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| Address |
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| Education Background |
Name of the secondary school(s) attended
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School qualifications gained
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IELTS/TOEFL Score
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Upload evidence of these secondary qualifications
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Tertiary Institution(s) you have attended
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Qualifications gained
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Upload evidence of these tertiary qualifications
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| Work Experience |
Job roles you have held
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Upload evidence of these job roles
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| Special Needs |
Please list and specific special needs you have (eg. medical, learning)
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| Accommodation and Arrival Services |
| Do you want NCBT to arrange a home stay for you? |
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| What type of accommodation do you want us to arrange? |
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| Do you want NCBT to arrange an Arrival Service? |
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| Please visit www.ncbt.ac.nz for a full outline of these services and their respective costs. |
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2011 Course Intakes (Please tick preferred course and intake date)
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| All courses are approved by the New Zealand Qualifications Authority (NZQA) |
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| Method of Payment |
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Code of Practice for the Pastoral Care of International Students
NCBT has agreed to abide by the above code. Copies of the code are available from NCBT or from the New Zealand Ministry of Education website: www.minedu.govt.nz
If students are unhappy with the service provided by NCBT they can contact the International Education Appeal Authority, Private Bag 47-911, Wellington. |
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| How did you hear about NCBT? (Please select) |
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| Application Checklist (Please select) |
Have you:
Completed all sections of this application form
Enclosed a copy of your passport
Enclosed verified copies of your academic records
Enclosed work experience records
Enclosed a resume or curriculum
Enclosed evidence of English test result |
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Declaration
I declare that the information given in this application is true and correct and no information that would have any effect on my enrolement with NCBT has been withheld. I understand that NCBT reserves the right to cancel the Offer of Place made on the basis of incorrect information.
I have read and accepted the Conditions of Enrolement as stated in the "Information for Prospective Students" Pack and agree to adhere to the Student Code of Conduct established by NCBT
I authorize NCBT to collect, use and disclose personal information about me in accordance with the conditions of enrolement. |
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I accept the above declaration
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