Domestic Application Form

Please read all the instructions carefully before you complete this form or email us at enquiries@ames.ac.nz.

The purpose of this application form is to gather all of the information needed for AMES personnel to be able to contact you in regards to your submission to partake on an AMES I.T. Academy course. The information is also needed as a requirement of the Ministry of Education and other Government agencies for statistical purposes.

Course Name*

Campus*

Start Date*

Family Name*

Given Name*

Preferred Name

Title*

Gender*

Male
Female

Date of Birth*

Open the calendar popup.

Phone*

Mobile

Email*

Home Address

Address*

Suburb/Town

City*

Postal Code

Country*

Postal Address (if different from above)

Address

Suburb/Town

City

Postal Code

Country

Citizenship

Citizenship*

If New Zealand Permanent Resident or Other, please specify

If Other, Passport number

What ethnic group(s) do you belong to? You may tick up to three boxes that apply to you.* Pakeha / NZ European British / Irish Dutch Greek Polish
South Slav Italian German Australian Other European
New Zealand Maori Samoan Cook Island Maori Tongan Niue
Tokelauen Fijian Other Pacific Island Filipino Cambodian
Vietnamese Other SE Asian Chinese Indian Sri Lankan
Japanese Korean Other Asian Middle Eastern Latin American
African Other Not Stated

What was your main activity or occupation in New Zealand at 1st October last year?*	Have you completed secondary school?* Yes No	How many years did you attend?
What was the name of the last secondary school you attended*	City	Country
What was the highest level of achievement you hold from secondary school?*	Will this be the first year you have ever enrolled in a University, Polytechnic, College of Education, Private Training Establishment, or Wananga either in New Zealand or overseas since leaving school* Yes No
If you answered “No”, please specify the following:
Name of Institution	Country	Programme of Study
Years Attended	Did you complete the academic requirements in order to graduate? Yes No