Construction and Infrastructure Enrolment Form

Name | Ratou Ingoa(Required)

First Names | Tōu Ingoa Tuatahi Last Name | Tōu Ingoa Whakamutunga

Preferred first name | Tōu Ingoa hiahia ake

Preferred First Name

Previous names known by | Tōu Ingoa o mua

First Names | Tōu Ingoa Tuatahi Last Name | Tōu Ingoa Whakamutunga

Preferred Title | Tōu taitara hiahia ake(Required)

Gender | Ira tangata(Required)

Male

Female

Diverse

Date of birth | Tōu ra whanau(Required)

Email | Tōu Īmera(Required)

NSN Number (if known)

Address | Tōu Wāhitau(Required)

Address | Tōu Wāhitau City | Te taone ZIP / Postal Code Country | Te whenua

Day Time Phone | Tōu waea I te ra(Required)

Evening Phone | Tōu waea I te po

Mobile | Tōu waea pūkoro

Next of Kin | Tōu whanaunga

Name | Ratou Ingoa(Required)

First Names | Tōu Ingoa Tuatahi Last Name | Tōu Ingoa Whakamutunga

Relationship to You |(Required)

Phone | Ratou waea(Required)

Address | Tōu Wāhitau(Required)

Address | Tōu Wāhitau City | Te taone ZIP / Postal Code Country | Te whenua

What Location do you intend to study from?(Required)

Which Programme are you Enrolling in?(Required)

This particular course at this location is only offered Full Time.

What date are you planning to start your Programme with LBT?

Have you studied with Land Based Training before? | I ako koe ki te LBT I nga tau e mua(Required)

Yes | Āe

No | Kaore

How did you hear about us? | I pehea koe I ako ai mo matou?(Required)

If you selected other please let us know where you heard about us... |(Required)

What was the name of the last secondary school you attended? | He aha te Ingoa o tōu kura tuarua whakamutunga?(Required)

What was your last year at secondary school? | He aha te tau I oti ia koe I te kura tuarua?(Required)

What is the highest level of achievement you hold from Secondary school? | He aha te tohu o to kura teitei?(Required)

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 | Koinei tonu to tau tuatahi I nga Whare Wananga o Aotearoa, o Tāwāhi ranei mai I te wa o te kura tuarua? Kati nga STAR, community me he hobby akoranga.(Required)

Yes | Āe

No | Kaore

Attach verified ID here |

This must be a Passport, Birth Certificate or Marriage Certificate to be an acceptable form of ID.

Max. file size: 2 MB.

Do you need LBT to order a Birth Certificate for you?

Yes

No

For us to move forward with ordering a birth certificate on your behalf please provide the following information:

Place of Birth

Mothers Name

First Last

Fathers Name

First Last

Privacy – Land Based Training collects and stores information from this form to:

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

In signing this enrolment form you authorise the disclosure of your personal information on the understanding that Land Based Training will comply with the legal requirements in relation to the use and disclosure of personal information, as set out in the Privacy Act 2020, the Education and Training Act 2020 and other relevant legislation. You are entitled to see any information that Land Based Training holds about you and request to correct 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 individuals. The Privacy Act requires Land Based Training to collect, hold, handle, use and disclose personal information in accordance with the twelve information privacy principles in the Act. http://legislation.govt.nz/act/public/1993/0028/latest/DLM296639.html?src=qs. From 1 December 2020, the Privacy Act 2020, which contains the same privacy principles and governs the collection, use, storage and disclosure of personal information. Supply of Information to Government Agencies and Other Organisations Land Based Training supplies data collected on this form to government agencies, including:

the Ministry of Education
Education New Zealand
the New Zealand Qualifications Authority
the Tertiary Education Commission
the Ministry of Social Development and Inland Revenue
Immigration New Zealand (for those who are not New Zealand citizens or permanent residents) and the Ministry of Business, Innovation and Employment
agencies which support particular students through community support, 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 2020. When required by law, Land Based Training 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. Land Based Training policy on withdrawal and refund of fees may be obtained from our Head Office, 0508 872 466. Rules – In signing this enrolment form you undertake to comply with the published rules and policies of Land Based Training with regard to attendance, academic integrity and progress, conduct and use of information systems. Student Images Release – I hereby give Land Based Training permission to use my image in any publicity, promotion or marketing material.

Declaration |(Required)

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.

Phone

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

Construction and Infrastructure Enrolment Form

Next of Kin | Tōu whanaunga

Contact Info