NZPTC Online Diploma Enrolment

C O M P U T E R ,O B U S I N E S S O&O H O S P I T A L I T Y OT R A I N I N G

Online Diploma Enrolment

Surname :

Other Names :

Residential Address :

Postal Address :

E-mail Address :

Phone Contact : Home Business Mobile :

Date of Birth (DD/MM/YY)

Father's Name :

Father's Occupation :

Mother's Name :

Mother's Occupation :

Type of Course

Course Applied For :

Mode of Study :

Semester :

Payment Method:

Cash Installments FNPF (FNPF Number: )

Academic Qualifications

Name of Secondary School :

Level Attained (eg. Form 6):

Year Completed :

Education Since Leaving School

	Course Name	Institution	Duration	Date Completed
1
2
3

Work Experience

	Date Worked	Occupation	Company	Location	Fulltime/ Part-time
1
2
3

DECLARATION

I certify that all the details given on this form are correct and that I will observe such rules and conditions as may be required by NZPTC should my application be successful.

________________________________________

Date :

For Official Use Only:

Application Approved :

Student informed of approval :

Fees schedule/ contract signed and attached :

________________________

Date : __________________

CENTRE MANAGER

S H A P I N G I Y O U R I F U T U R E I W I T H I T E R T I A R Y I E D U C A T I O N