NZIHT Short Course Application

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New Zealand School of Engineering, Energy and Infrastructure

NZIHT Short Course Application

Personal Information

Email Address *

Please enter your email address.

Legal First Names *

Your first name is required.

Legal Surname *

Your surname is required.

Preferred First Name *

Your preferred first name is required.

Previous Names (if any)

Gender *

Please select your gender.

Date of Birth *

Please enter your date of birth.

Postal Address

PO Box number preferred *

Suburb

City *

Postcode *

Country *

Mobile *

Phone

Select your course

Course(s)

Please select an option.

Citizenship

Please indicate your citizenship or resident status. *

Ethnicity

What ethnic group do you belong to? *

Ethnicity:

Iwi Option One:

Hapū:

Iwi Option Two (If applicable):

Iwi Option Three (If applicable):

Fees

How do you intend to pay your fees?

Is an organisation or company paying your fees?

If for any reason the organisation/company does not pay your fees, you will be liable for the full payment

Purchase Order Number

NZIHT is a division of Te Pūkenga trading as WITT. Please generate your purchase order number under the company name Te Pūkenga trading as WITT.

Organisation/Company Name *

Authorised Contact Person *

PO Box number preferred *

Suburb

City *

Postcode *

Contact Person Email *

I have read the Declaration and agree to its terms and conditions *

Terms and conditions must be agreed to.