Professional Development Enrolment Form

Student name and details

Title

Last name

First name

Legal middle name

Preferred name

Previous family name(s)

Previous given name(s)

Gender

Date of Birth

Have you previously enrolled at this institution?

Ara Student ID (if known)

NSI or NZQA No. (if known)

Citizenship (Nationality)

Residency Status

If you are from overseas, are you in New Zealand on a student visa?

Your contact details

Number/flat and street name

Suburb

Town/City

Postcode

Email

Phone Number

Emergency contact

Full name

Phone

Relationship to you

Course

Course name

Course code

Course start date

Your ethnicity

Company / Organisation (if applicable)

Payment details

How do you intend to pay your fees

If you are paying by cheque, EFTPOS, or cash, you can do so at the Ara Student Finance counter at any at any of our campuses.

Paying by Direct Credit

Go into your online banking site and pay your fees into Ara BNZ account 02-0800-0911670-003

Paying by Credit Card

Ara accepts American Express, Mastercard and Visa

Pay by credit card in person at the Student Finance office OR
Phone our Contact Centre on 0800 24 24 76

Company/Business Paying

Please attach a letter or purchase order number from the organisation/company paying your fees to that effect.

If for any reason the organisation/company does not pay your fees you are still liable for all fees invoiced to you.

Name or Organisation

Authorised contact person

Invoice address

Phone number

Letter or purchase order number attached from company/organisation confirming payment of fees

Your acknowledgement and declaration

To view Ara Policies and Procedures and Terms and Conditions of Enrolment see:

By submitting this form, I agree to read, understand, and comply with the Ara Terms and Conditions of Enrolment; Ara Policies and Procedures; and the published programme rules of Ara Institute of Canterbury Ltd – including but not limited to Personal Information and Privacy Principles, Ara Fee Payment and Ara Student Rights and Responsibilities. I agree

I understand and agree that Ara Institute of Canterbury Ltd will collect, store, use and disclose personal information for the purpose of conducting its normal and proper business. I have read and understand how such information will be managed and disclosed in accordance with the Privacy Act 1993, Education Act 1989 and any other relevant legislation. I agree

I declare that to the best of my knowledge all of the information supplied for this application is true and complete. I acknowledge that the submission of fraudulent, forged or otherwise dishonest documentation in support of this application will automatically disqualify me from enrolment. I am the person named on this form. I agree

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