1st Year

LIFE LEADERSHIP COLLEGE ENROLMENT FORM

25 Normanby Road, Mt Eden, Auckland 1024
Phone: 09 306 4222
Email: info@life.ac.nz

The purpose of this enrolment form is to obtain from you the information we need to enrol you into a qualification at LIFE Leadership College. We also need to collect information from you which is required by government agencies for statistical and registration reasons. Please fill in the form properly by completing all sections of the form.
Name
As it appears on your birth certificate/ Passport
Date of birth
You may choose one option
(for students with dual citizenship, please specify the country of citizenship on the passport you used or will use to enter New Zealand)
Please select if you have either of the below:
Ethnicity
Please indicate which ethnic groups you belong to. (You may tick up to three boxes.)
(You may enter more than one iwi. If you do not know your iwi, please enter "I don't know".
*You can check whether you are eligible for FeesFree at https://www.feesfree.govt.nz/ Please note that you may be eligible for Fees Free but not have any entitlement remaining. Please visit their website for more information.
Permanent Home Address:
(i.e. where you grew up, family/siblings, where you have lived and are living).
Have you ever suffered from or been involved with:
(Please tick as many as appropriate. This information will be kept extremely confidential.)
Next of Kin / Emergency Contact Name
Next of Kin / Emergency Contact Address:
PRIVACY
LIFE Leadership College collects and stores information from this form to: - Manage the business of LIFE Leadership College (including internal reporting and administrative processes) - 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 signing this enrolment form, you authorise the disclosure of your personal information on the understanding that LIFE Leadership College will comply with the legal requirements in relation to the use and disclosure of personal information, as set out in the Privacy Act 1993 (shortly to be replaced by the Privacy Act 2020), the Education and Training Act 2020 and other relevant legislation. You are entitled to see any information LIFE Leadership College holds about you and request to correct any errors in that information. To do so, contact the Registrar. NB: The Privacy Act came into force on 1 July 1993 with the stated aim of protecting the privacy of individuals. It requires LIFE Leadership College 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 From 1 December 2020, the Privacy Act 1993 will be replaced by 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 LIFE Leadership College supplies data collected on this form to government agencies, including: the Ministry of Education; Education New Zealand; the New Zealand Qualifications Authority (NZQA); the Tertiary Education Commission (TEC); the Ministry of Social Development (in relation to student loans and allowance) 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 and the administration of the Fees-Free and Fees-Free Trade Training initiatives; develop policy advice for government; and 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. On occasion, more than one National Student Number is created for an individual or data entry errors are made. The Ministry regularly monitors the quality of the National Student Index and, when duplicates or errors are discovered, it works with providers and government agencies to merge duplicates and correct errors. This may require the documentation you provide at enrolment being shared between agencies authorised to access the National Student Index to make these corrections. For further information, please see: http://nsi.education.govt.nz/home.aspx 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 (and, after 1 December 2020, the Privacy Act 2020). When required by law, LIFE Leadership College 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.
REFUND INFOMATION
If a student wants to withdraw from the programme, they or their legal guardian (for students who are under 18 years of age) must apply in writing using a Withdrawal Request Form obtained from the Registrar. The following refund arrangements apply (as required by NZQA): For programmes of 13 weeks and greater: Within the first 10 working days of the programme: Domestic students: Full refund less $500 or 10% of the programme fees (whichever is lesser). The date on the signed withdrawal form will determine the programme withdrawal date. International students: A full refund, less costs incurred by the College related to the student's enrolment. The maximum amount LIFE Leadership College may retain of fees paid by an international student who withdraws within the refund period is 25%. The date on the signed withdrawal form will determine the programme withdrawal date. After more than 10 working days of the programme: No refund after this date. The date on the signed withdrawal form will determine the programme withdrawal date. All students are liable for the cost of any additional services requested if these have already been incurred on behalf of the student, or rendered and/or completed prior to a cancellation. No refund of fees or extension of course will be given if the student: - Arrives late for their course without notifying LIFE Leadership College - Takes times off which exceeds approved holiday - Leaves before the course is finished. If a student defaults on any fee payments, the cost of debt recovery will be the student's responsibility. LIFE Leadership College reserves the right to charge interest (currently at 11% P/A) on any outstanding debt. After more than 10 working days of the programme: No refund after this date. The date on the signed withdrawal form will determine the programme withdrawal date.
CANCELLED PROGRAMMES AND PAPERS
LIFE Leadership College reserves the right to cancel or postpone any courses and/or programmes and shall not be liable for any claim other than the proportion of course/programme fee which the cancelled portion bears. Courses and programmes may be dependent upon the number of enrolments and/or any other factors.
DOCUMENTATION
To qualify as a domestic student, and so be entitled to the Government tuition subsidy, you must be: A citizen of New Zealand (including students from the Cook Islands, Tokelau, or Niue who have New Zealand citizenship) or A permanent resident of New Zealand or A citizen or permanent resident of Australia residing in New Zealand or A citizen of New Zealand (including students from the Cook Islands, Tokelau, or Niue who have New Zealand citizenship). You must provide evidence of citizenship or permanent residency. To do so you must produce one of the following: Birth certificate with place of birth stated as New Zealand, Cook Islands, Tokelau, or Niue. New Zealand passport. A certificate of identity. A statement of Whakapapa, including date of birth, countersigned by a kaumatua. A New Zealand certificate of citizenship. Overseas passport with residency stamp. You can bring the original documentation with you to the interview, alternatively please provide a certified copy. This means a photocopy, photograph or scanned copy of your original document, signed as being a true and accurate copy by a Justice of the Peace (JP), Barrister or Solicitor, Notary Public, Court Register or Deputy Registrar, Member of Parliament, Land Transport New Zealand, Public trust, or local authority employee designated for this purpose. When a learner is in a remote community and unable to access a person listed in the Oaths and Declarations Act, a member of the New Zealand Police, school principal, minister of religion, or general practitioner is acceptable. International students must bring their passport with them when they enrol.
Please read the following declaration and sign below.
I agree to abide by the statutes, regulations and policies of LIFE Leadership College. I am aware that this agreement is subject to the laws of New Zealand. The liability of LIFE Leadership College shall not exceed an amount equal to the fees paid by the student to LIFE Leadership College. I declare that the information I have supplied on this form and any attached documentation to be true and complete and that I have personally completed the form. I have not withheld information which could have a bearing on my enrolment or the conditions of my enrolment. I acknowledge that LIFE Leadership College may suspend or terminate my enrolment if false information has been supplied or required information is not supplied by the due date. LIFE Leadership College reserves the right to inform all other New Zealand education institutions, Immigration New Zealand, and New Zealand Police, of such cases including the student’s name and date of birth. I understand that all documents submitted with this application become the property of LIFE Leadership College and will not be returned to applicants. I agree to supply further documentation requested by LIFE Leadership College for the purpose of my enrolment and I authorise LIFE Leadership College to release information regarding my application to Immigration New Zealand (INZ) and the Department of Labour where LIFE Leadership College considers the information relevant to my immigration status. I have read and understood the outline of how the Privacy Act will be applied in LIFE Leadership College, and I authorise LIFE Leadership College to collect, use and disclose personal information about me in accordance with that outline and the Privacy Act 1993. I authorise any agency holding the source of any information I have provided on this form to release that information to LIFE Leadership College upon request. I am aware that the payment for my tuition and/or other fees needs to be paid in full directly to LIFE Leadership College’s Public Trust account as detailed in the Offer of Place letter by the payment date if I wish to proceed with my enrolment. I have also read and accepted LIFE Leadership College’s refund policy.
Date