A. Programme Select a programme Select the courses for which you want to enrol: TOPS-Accounting and Office administration TOPS-English as a Second Language TOPS-Real Esate Youth Courses National Certificate in Social Services Certificate in Computing and Information Technology Certificate in Computer Graphic Design Advanced Certificate in Computer Graphic Design Study history Have you studied at Target Education before? Yes No If you answered Yes, was this a: Skill NZ programme? Student ID number WINZ program? Customer Service number Ministry of Education programme? Student ID number Private? Student identification number NZQA identification If you are registered with NZQA and have an NZQA student identification number, please type it here:
B. Personal Details
Title	Mr Mrs Ms Miss Other... Other
First name
Preferred first name
Middle name
Family Name
	If you have previously enrolled under another name, what was that name?
Home address
Phone
e-mail
Date of birth
Gender	Male Female
Citizenship and Residency: NZ Citizen NZ Permanent resident Australian Citizen Other, please specify Other If "Other" please specify your fee assistance status as: MFAT Scholarship Full fee paying Exchange student Foreign wholly research PostGrad Military, diplomatic Operation Deep Freeze Ethnicity: What ethnic group(s) do you belong to? (You may tick up to three boxes which apply to you.) European/Pakeha or New Zealand European New Zealand Maori Samoan Cook Island Maori Tongan Niuean Tokelauen Fiji Islander Other Pacific Island Chinese Indian Other Asian Other Iwi: If you are a New Zealand Maori, please state your main tribal affiliation:
Medical and Emergency Details Do you live with effects of significant injury, long term illness or disability? No Yes If Yes please specify your medical condition or needs: Are you on any medication? No Yes What is the name of your doctor? Phone number: Emergency contact person Phone number
C. Academic and vocational information Prior activity What was your MAIN activity or occupation in New Zealand at 1 October last year? Secondary school student Unemployed or other beneficiary Wage or salary worker Self employed University student Poytechnic student College of education student House-person or retired Overseas Private training establishment student Wananga student Other, specify If other please specify: Secondary school What was the name of the last secondary school you attended?  (state "overseas" if applicable) What was the final year you attended secondary school? What is the highest secondary school qualification you hold? No secondary qualification School certificate Sixth form certificate University Entrance (before 1986) Higher school certificate Entrance qualification B Bursary A Bursary Scholarship Overseas award Other None of the above If either "Overseas award" or "Other", please specify What was the year you gained your highest secondary school qualification? Training history Will this be the first year you have ever enrolled in Private Training Establishment, University, Polytechnic, College of Education or Wananga since leaving school Yes No If no, what was the first year of enrolment? What was the name of the institution? What was the name of the course? Did you achieve any unit standards? (If yes, you will need to provide a NZQA Record of Learning) Yes No Have you previously held a student loan? Yes No If yes, please enter the year of study: If yes, please enter the student ID from your previous institution: Do you expect to complete the academic requirements in order to graduate from your programme of study this year? Yes No Is your overall programme of study: Full time or Part time
D. Statistical information How did you hear about Target Education? Work and Income NZ Radio Workbridge Newspaper Self referred Other
Declaration Privacy The Institute collects and stores information from this form to comply with the requirements of the Ministry of Education (funding and student statistical returns), New Zealand Qualifications Authority (Record of Learning registration and Unit Standard outcomes), Education and Training Support Agency (funding and student statistical returns), Industry Training Organisations (funding and academic outcomes) and Work & Income New Zealand (confirmation of enrolment and academic outcomes). The information is also used to select students for programmes, to manage internal administrative processes, and for internal reporting. Information about students may be supplied to, and sought from, other educational institutions for the purpose of verifying academic records. In addition, when required by statute, the Institute releases information to Government agencies such as the New Zealand Police, Department of Justice, Work and Income New Zealand, and the Accident Rehabilitation Compensation Corporation (ACC). In completing this enrolment form you authorise such disclosure on the understanding that the Institute will observe the general conditions governing the release of information, as set out in the Privacy Act 1993. You may see any information held about you and amend any errors in that information. To do so, contact the Enrolments Officer. Fees In submitting 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 Institute's policy on withdrawal and refund of fees may be obtained from the Enrolments Officer. Rules By clicking on the Submit button on this enrolment form you undertake to comply with the published rules and policies of the Institute with regard to attendance, academic progress, standard of dress, health and safety, and behaviour. I declare that to the best of my knowledge all the information supplied on 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.