Enrolment application form - part 1 (of 3)

Welcome to the Otago Polytechnic. We hope your time with us is enjoyable and you find your study with us beneficial. If you have any questions about your application/enrolment, please call customer services on 0800 762 786.

Programme(s) applying for

First option:

  • Dunedin
  • Cromwell
  • Wanaka
  • Wintec (Hamilton)
  • Online
  • Distance

  • Full-time
  • Part-time


Alternative option:

  • Dunedin
  • Cromwell
  • Wanaka
  • Wintec (Hamilton)
  • Online
  • Distance

  • Full-time
  • Part-time
Personal details

Name, title and gender

Please note

Fields marked with an asterisk* must be completed to successfully submit the form.

What happens to your details?

Please note that your name, date of birth and residency as entered on this application/registration will be included in the National Student Index, and will be used in an Authorised Information Matching programme with the New Zealand Birth Register. For further information please see https://nsi.education.govt.nz.

  • Miss
  • Mrs
  • Ms
  • Mr
  • Dr
  • Other:

  • Female
  • Male

If you have previously been enrolled at Otago Polytechnic, what were you previously known as?
Status

Citizenship and/or Residency

Citizenship/Residency

If you were not born in New Zealand, we will need to see your passport from another country showing a current New Zealand Resident's Visa. This may be asked for at time of enrolment. If you do not hold a residency visa you will need to contact the International Centre on: 0800 762 786.

Select your citizenship or permanent residence status:*

  • New Zealand Citizen (including Cook Islands, Tokelau or Niue)
  • New Zealand Permanent Resident (a verified copy of a passport with NZ Permanent Resident Visa may be asked for at time of enrolment)
  • Australian Citizen or Permanent Resident

Ethnic group(s):

Ethnic group(s) you identify with (you can tick up to 3 boxes):*







Iwi(s):

Source

Statistics New Zealand, New Zealand Standard Classification of Iwi

If you are NZ Māori, please state those Iwi with which you have an affiliation.

Iwi 1:

Iwi 2:

Iwi 3:
Contact Details
Contact details

Please contact Customer Services directly or in writing, if your contact details change. Tel:0800 762 786.

Home/permanent address:

 

 

 


Email address(es):


Employer name and address (if applicable):

 


Contact address while studying (if different from permanent address):

 


Emergency contact:

In an emergency, who do you want us to contact?

Relationship

e.g. friend, mother, brother, whānau


What address shall we post correspondence to?

  • Home/permanent address
  • Employer
  • Contact address while studying

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