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Quantum Education Group Qe group international application form
Surname (as shown on your passport)
Date of Birth (DD/MM/YY)
English Language (please specify)
New Zealand Diploma in Business
Culinary Arts (please specify)
Hotel Management (please specify)
Tourism Management (please specify)
Professional Counselling (please specify)
Other (please specify)
PLEASE INDICATE WHICH PROGRAMMEYOU WISH TO APPLY FOR:
PLEASE REFER TO OUR LATEST DATES & FEES SCHEDULE
QUANTUM EDUCATION GROUP
PO BOX 13121,Tauranga 3141, NEW ZEALAND
FREEPHONE (NZ ONLY) | 0508 267 767
TELEPHONE | +64 7 571 2800 FAX | +64 7 578 1032
EMAIL | firstname.lastname@example.org
Please complete this form in English and submit it, along with the required support documents, to email@example.com
Alternatively, you may send the documents by post to the above address. Once your eligibility has been assessed, an offer letter and
supporting documents will be sent to you. Please note that your enrolment will not be complete until all of the forms have been filled out
and accepted. For information about required support documents and to help us expedite your application, please refer to the checklist
at the end of this form. Should you have any questions about the courses or the enrolment process, please do not hesitate to contact us.
QUANTUM LEARNING / QUALITY EDUCATION
INTERNATIONAL APPLICATION FORMInternational
Preferred Start Date Course Fee: NZ$
FemaleGender (please tick) Male
Please refer to our international prospectus regarding the required level of English for the course you are applying for.
If English is not your first language, please indicate your level of English proficiency:
Please write a short essay (around 100 words) explaining why you are interested in the chosen programme of study. If you have
completed previous studies in that field, or if you have relevant work or life experience, include these details as well.
If space is not sufficient, you may submit the essay as a separate document.
Do you live with the effects of significant injury, long-term illness or disability? (please tick)
If yes, my disability affects me in the following ways:
Please state any medical condition that may affect your training:
What was your MAIN activity or occupation at 1 October last year:
IELTS Score TOEFL Score
DISABILITY (The information you supply is confidential)
Visual Verbal Communication Written Communication Learning Mobility
Travel and medical insurance is compulsory for international students studying in New Zealand. The insurance can be arranged for
you (additional fees apply). Evidence will be required if a student has already arranged their own insurance, which needs to meet the
guidelines set out in the Code of Practice. Please indicate if insurance is required:
Full board homestay with carefully selected host families can be arranged for you in Kerikeri.
In Auckland, we use the homestay agency Host Families NZ. Quantum can put you in touch with the agency to arrange the booking.
Please see www.qegroup.co.nz/accommodation for full details.
An application placement fee of NZ $200 applies. Alternatively students can arrange their own accommodation.
Please indicate which type of accommodation you will be living in:
Please note if you have studied in New Zealand previously you will need to supply NZIS with an attendance record.
ACADEMIC ANDVOCATIONAL INFORMATION
I wish for QE Group to arrange my insurance. The fee will be added to my invoice.
I will arrange and provide evidence of my own insurance, which meets the guidelines set out in the Code of Practice.
Other (please specify)
Address (if available yet)
For Homestay please state the duration you wish to book accommodation for:
Homestay Hotel/ Motel Hostel Flat
If you chose ‘Homestay’ please complete the following questions:
Do you have any allergies? If yes, please list them:
Do you have any special dietary needs? (e.g. Vegetarian, Halal)
Are you comfortable with pets in the home?
Would you prefer to live in a household with or without children?
What are your interests and hobbies?
Without Don’t mind
Do you smoke?
What was your last year at secondary school?
What is the highest level of achievement you hold from a secondary school?
How did you find out about the programme that you are enrolling in?
Agency Name (if applicable)
Will this be the first year you have enrolled at a University, Polytechnic, College of Education,
or Private Training Establishment either in New Zealand or overseas since leaving school?
If “No,” please provide the year of your first enrolment in a tertiary institution:
Will you be applying for Transfer of Credits?
The aim and outcome of the course
The course entry criteria
To be eligible for the qualification, I must pass the required
unit standards/exams (respectively)
(No qualifications are guaranteed)
I am required to attend my course at all times, unless I have
genuine reasons for my absence
Minimum course contact time and self-directed learning
Course withdrawal, fee refund and fee protection policies
Code of Practice Summary
Student Concerns Procedures & Form
I am free from alcohol and drug addiction and lead a
I agree to notify the school of any change in contact details
My expectations are appropriate
My literacy and numeracy abilities are sufficient to
undertake the course
The Declaration of Possible Conflicts of Interest
I am of 18 years (Counselling: 20 years) or older
Counselling students only: I am required to undertake
personal counselling for myself as part of the training for
the diploma. I agree to receive personal counselling at
my own cost
I HAVE PROVIDED THE FOLLOWING DOCUMENTS
(MUST BE ORIGINALS OR CERTIFIED COPIES):
Evidence of English Proficiency (IELTS or TOEFL)
Evidence of previous qualifications and/or academic
Counselling only: Police and Traffic Record for all countries
lived in for over 6 months within the last 5 years
Counselling only: Details of two referees with name,
phone, and email address
Only those who have studied in New Zealand previously:
I have read the below, received the relevant information and by signing agree that I fully understand the following:
You can find the Course Prospectus, Student Handbook, Refund & Fee Protection Policy, Code of Practice Summary, the Declaration
of Possible Conflicts of Interest, Student Concern Form & Process and Southern Cross Insurance Information Leaflet on our website
under www.qegroup.co.nz/downloads/ Please contact us if you require any of these documents to be sent to you.
Signature of Student Date
Declaration 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. I undertake to read the Student Handbook
and understand that the rules and procedures contained therein are conditions of my enrolment.
07 | 08 | 2013
Privacy Quantum Education Group collects and stores information from this
form to comply with the requirements of the Ministry of Education (student
statistical returns), New Zealand Qualifications Authority (Record of Learning
registration and Unit Standard outcomes), Tertiary Education Commission
(funding returns), Industry Training Organisations (funding and academic
outcomes), Ministry of Social Development (confirmation of enrolment and
academic outcomes), Inland Revenue Department (student loan interest rebate),
Department of Immigration (if you are not a New Zealand citizen or permanent
resident) and Agencies who support particular students through scholarships and
prizes, payment of fees or other awards (if you are a recipient of one of these
The information is also used to select students for qualifications, to manage
internal administrative processes, and for internal reporting. Information about
students may be supplied to, and sought from, other educational institutions for
the purpose of verifying academic records.
NB The Privacy Act came into force on 1 July 1993 with the stated aim of
protecting the privacy of natural persons.
It requires Quantum Education Group to collect, hold, handle, use and disclose
personal information in accordance with the twelve information privacy
principles in the Act. For further information please see http://www.privacy.org.
nzpeople/peotop.html. Please note that your name, date of birth and residency
as entered on this enrolment 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 see http://www.nsi.govt.nz/ima.
In addition, when required by statute, Quantum Education Group releases
information to Government agencies such as the New Zealand Police,
Department of Justice, Ministry of Social Development, and the Accident
Compensation Corporation (ACC).
In signing this enrolment form you authorise such disclosure on the understanding
that Quantum Education Group will observe the general conditions governing
the release of information, as set out in the Privacy Act 1993 and the post-
compulsory Unique Identifier Code of Practice. You may see any information
held about you and amend any errors in that information. To do so, contact the
Student Services Manager.
Fees In signing this enrolment form you; agree to pay all fees as they become
due, and to meet any late fees and collection charges associated with debt
recovery. You understand and agree to the terms and conditions of Quantum
Education Group’s withdrawal and refund policy.
Rules In signing this enrolment form you undertake to comply with the published
rules and policies of Quantum Education Group with regard to attendance,
academic progress, standard of dress, health and safety, and behaviour.
NZQA Provider Category and Statement of Confidence Quantum
Education Group of providers achieved a statement of Confident in its
educational performance and its capability in self-assessment. It is recognised as
a category 2 provider by NZQA.