Apply Now - eCampus NZ

Thank you for your interest in eCampus NZ and our range of flexible online courses.

If you would like to study one of our online certificates and diplomas, please complete the application form below.

Are you a current learner wanting to enrol for your next course or re-enrol? Please contact our sales team on [email protected] or call 0800 328 269.

If you would like to study one of our short courses, you can apply directly through the course page. View our short courses

This application form should take approximately 10-15 minutes to complete. Once we receive your application, we'll be in touch by phone, or email as soon as we can.

Need help?

If you need assistance, please contact one of our enrolment coordinators at [email protected] or call 0800 328 269 and press 1.

Personal Details

Legal Name*

Title First Middle Last

Preferred First Name

Previously Given Names

Date of Birth*

Gender*

NSN (National Student Number)

What was your main activity or occupation on 1 October last year?*

Contact Details

Mobile Number*

Phone Number

Email Address*

Address*

Street Address Address Line 2 City Post Code Country

Emergency Contact Name*

Emergency Contact Relationship*

Emergency Contact Mobile*

Emergency Contact Phone

Citizenship

Country of Citizenship*

Residency*

Ethnicity 1*

Ethnicity 2

Ethnicity 3

Iwi 1

Iwi 2

Iwi 3

Support

Have you been diagnosed with a learning difference – such as ADHD/ADD, ASD (includes Asperger’s), Dyslexia, Dysgraphia, Dyscalculia – or do you feel that you may require additional support with your learning?**

Yes
No

Details of Support

Please indicate your learning difference and/or provide details about how we can support you with your learning. If you received learning support at school, you may choose to provide details about the support you received.

Have you studied online before?*

Yes
No

Is English your first language?*

Yes
No

How many years of study have you completed in the English language, with English used as the main language of instruction?

Qualification

Qualification / Program of Study*

Previous Education

Last secondary school*

Approximately what year did you leave secondary school?*

Highest Secondary School Qualification*

First Year At Tertiary Study*

Marketing

How did you find out about eCampus NZ?

Declaration

I declare that to the best of my knowledge all the information supplied on, and with, this application form is true and complete, I agree to abide by the Terms and Conditions described above, and I consent to the disclosure of personal information as described in the Privacy statement.

Yes

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Comments

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