Enrolment application

Enrolment application – New Zealand College of Chinese Medicine

Welcome to the New Zealand College of Chinese Medicine.
Please read the instructions below carefully before you complete this enrolment form.

Click here to download a copy of the 2025 Domestic Students enrolment form.

Click here to download a copy of the 2025 International Students enrolment form

Click here to download a copy of the 2025 Bachelor Degree Interview form

Click here to download a copy of the 2025 Master Degree Interview form

INSTRUCTIONS

The purpose of the enrolment form is to get the information we need to enrol you into a qualification at NZCCM. We also need to collect information as required by the Ministry of Education and other Government agencies. Please fill in the form by:

Completing all sections of the form.
Printing your answers clearly in pen, or ticking the box that applies for multi-choice questions.
Signing the form.
Attaching to the form the additional documentation that is required for Ministry of Education and Tertiary Education Commission purposes. A description of the required documentation is provided on page 4 of the form.

If you area a Domestic Student (NZ citizen or permanent resident after two years) please pay the $200 enrolment fee to NZCCM Account number: 12-3021-0350521-00 at ASB Bank, Greenlane Branch, Auckland.

International Students please refer to the enrolment guidelines for International Students

Online Enrolment Form (在线报名申请表) 2025

Please note: All fields are required unless otherwise stated.

Step 1 of 9 - QUALIFICATION

IRD NUMBER COLLECTION FOR STUDENT LOAN INTEREST WRITE-OFF - (Domestic Students Only)
Do you currently have or will you have a Student Loan this year?*
- No
- Yes - Please enter your IRD number below (entering your IRD number is voluntary.)
- I am an International Student
IRD NUMBER
You may be entitled to have the interest on your loan written off for the period of your study. See IRD.govt.nz

Agent's Information
Are you using a student recruitment agent to assist you with this application*
- Yes
- No
If you answered yes to the above question please complete the following:
Agent's Name:
Company Name:
Address:
Phone Number:
Email Address:

DOCUMENTATION
Domestic students must provide evidence of citizenship or permanent residency by one of the following:
- Birth certificate with place of birth stated as New Zealand, Cook Islands, Tokelau, or Niue.</

- New Zealand passport.
- A statement of Whakapapa, including date of birth, countersigned by a Kaumatua.

- Certificate of citizenship or letter of confirmation.
- Overseas passport with residency stamp.

Domestic students must also provide provide verified copies of previous academic records.
You can bring the original documentation to Reception, or provide a certified copy.

International Students must provide certified copies of their passport and previous academic records when they enrol, and will require appropriate insurance.

Please note that your name, date of birth and residency as entered on this enrolment will be included in the National Student Index, and will be used in an Authorised Information Matching programme with the New Zealand Birth Register.
Upload Passport Copy or Birth Certificate Here*
Attach copies of the Passport Copy or Birth Certificate here. Please note, all documents uploaded required to be verified by a JP or other authorized official.
Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 5 MB.
Upload Past Qualifications Here*
Attach copies of Past Qualifications here. Please note, all documents uploaded required to be verified by a JP or other authorized official.
Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 5 MB.

YOUR CONTACT DETAILS
Address and contact details:
Permanent Address:*
Street Address Address Line 2 City ZIP / Postal Code Country
Phone*
Mobile:*
Fax:
Term Time Address: (if different from permanent address)
Street Address Address Line 2 City ZIP / Postal Code Country
Alternative Phone:
Email*
Enter Email Confirm Email
What is your postal address?*

Permanent Address

Term Time Address

Other
If you ticked "Other" please write your post address and code.
Street Address Address Line 2 City ZIP / Postal Code Country
Next of Kin:
Name:*
Address:*
Street Address Address Line 2 City ZIP / Postal Code Country
Next of Kin Phone:
Relationship to you:*
Do they speak English?

Yes

No

ENTRY PROFILE
NZCCM wishes to provide relevant and effective training. At the time of enrolment we collect information about your “entry profile”. Later we will collect feedback from you on your experience of studying with us, and about your employment and further training after you have finished your studies.

Please complete the questions below. The data is treated confidentially and we do not contact anyone named by you.

Education and Training
Previous Qualification:*

Where did you study the qualification?*

Did you complete this qualification?*

Yes

No
Did you study part time or full time?*

Full Time

Part Time
Employment
Position:

Employer:

Did you work part time or full time?*

Full Time

Part Time

Declaration
Privacy – New Zealand College of Chinese Medicine collects and stores information from this form to:
• Manage the business of NZCCM (including internal reporting, administrative processes and selection of scholarship and prize winners).
• Comply with the requirements of the Education Act 1989 and other legislation relating to maintenance of records and accountability for public funding.
• Supply information to government agencies and other organisations as set out below.

In signing this enrolment form you authorise such disclosure on the understanding that NZCCM will observe the conditions governing the release of information, as set out in the Privacy Act 1993, the Education Act 1989 and other relevant legislation. You may see any information held about you and amend any errors in that information. To do so, contact the Recruitment and Student Services Manager.

NB: The Privacy Act came into force on 1 July 1993 with the stated aim of protecting the privacy of natural persons. It requires NZCCM to collect, hold, handle, use and disclose personal information in accordance with the twelve information privacy principles in the Act which can be viewed on the Privacy Commissioner’s web site: http://www.privacy.org.nz/.

Supply of Information to Government Agencies and Other Organisations

NZCCM 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 who 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, if not already registered, 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 1993.

When required by law, NZCCM 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.

In signing this enrolment form you authorise such disclosure on the understanding that NZCCM will observe the conditions governing the release of information, as set out in the Privacy Act 1993, the Education Act 1989 and other relevant legislation.

You may request to see any information held about you and request that any errors in that information be amended or noted. To do so, contact registrar.

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. NZCCM’s policy on withdrawal and refund of fees may be obtained from the Recruitment and Student Services Manager.

Rules – In signing this enrolment form you undertake to comply with the published rules and policies of NZCCM with regard to attendance, academic integrity and progress, conduct and use of information systems.

Identity - If you have supplied a National Student Index number on this enrolment form, and your NSI status is Active, you are deemed to have declared that you are the legitimate owner of the claimed identity.

NZCCM reserves the right to reject any application on any grounds whatsoever without claim from the applicant.

The College reserves the right to:

• Alter the course content, provision, or fees for any course or programme subject to NZQA and TEC approval.
• Cancel a course or programme due to insufficient enrolment numbers.
• Change subjects delivered in any semester to meet exit qualification requirements.
• Make changes to its policies, procedures and requirements as deemed necessary, subject to Council and Senior Management approval.

Declaration:

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.

Signature (print name)*

Date:*
DD slash MM slash YYYY

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Documentation: Approved: Entered:

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Principals Approval (Master's degree only):

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Selma ID:

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Enrolment application