Enrolment Form

Instructions
Please fill in this online form properly by: ▪ Completing all sections ▪ Typing your answers clearly, or by ticking the box that applies for multi-choice questions.
Name of the Employer*
Employer Location: (Suburb and City)*
Tutor
Programme Start Date*
Date Format: DD slash MM slash YYYY
Your Position/Title*
Are you currently enrolled as a full time learner at another TEO, or Accessing literacy and/or numeracy training through another TEC funded literacy and/or numeracy provision for workplace training organisation?*
- Yes
- No

Preferred Title*
Name*
First Name Given Name
Preferred First Name
First
Previous name(s) known by
Date of Birth*

DD
MM
YYYY
Gender*
NSN Number (if known)

Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Day-Time Phone
Evening Phone
Mobile*
Email*

What was the name of the last secondary school you attended?*
What was your last year at secondary school?*
What is the highest level of achievement you hold from Secondary school?*
Will this be the first year you have ever enrolled in a University, Polytechnic, College of Education, Private Training Establishment, or Wānanga either in New Zealand or overseas since leaving school? Do not include enrolments in STAR, community or hobby classes*
- Yes
- No
If you answered “No”, please enter the name of the organisation you studied at and the year of your first enrolment:

If you haven’t provided an NSN number please attach verified ID here.
Accepted file types: jpg, jpeg, png, pdf, docx, doc.
If you have requested a student ID please attach head and shoulders photo here
Accepted file types: jpg, jpeg, png, pdf.

Privacy – Cornerstone Education collects and stores information from this form to:
- manage the business of Cornerstone Education (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
- 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 Cornerstone Education 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 Enrolments Officer. NB: The Privacy Act came into force on 1 July 1993 with the stated aim of protecting the privacy of natural persons. It requires Cornerstone Education to collect, hold, handle, use and disclose personal information in accordance with the twelve information privacy principles in the Act. http://www.privacy.org.nz/privacy-act Supply of information to government agencies and other organisations Cornerstone Education 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 1993. When required by law, Cornerstone Education 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. Cornerstone Education’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 Cornerstone Education 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. By ticking the box below I confirm that I have read and understand all conditions described above (including programme fee and enrolment obligations) and accept enrolment onto this programme of study with Aspire2 Business | Workplace Communication as part of Cornerstone Education Ltd (CEL). I confirm that I am the legitimate owner of the National Student Index Number provided on this enrolment form and if required, agree to provide any further documentation to validate my NSI number. I am aware of the conditions described above, and agree to abide by them. I consent to the disclosure of personal information as described above.*
- Yes
Click here to view the code of conduct.

Click here to view the Cornerstone Education terms and conditions.

Aspire2 Business | Workplace Communication Application Form

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Enrolment