New Zealand College of Chiropractic – Application Form

Application Details

Personal Details

This information helps us to support your journey as a student at NZCC. You are under no obligation to share this with us, and you can update or remove the information at any time while you are a student.
Please provide proof of your citizenship or residency status by uploading a certified copy* of one of the following documents:
  • Passport (preferred option) (If a New Zealand permanent resident, please provide proof of residency status)
  • Birth certificate (please provide official English translation if in another language)
  • State of Whakapapa, countersigned by a Kaumatua
  • A document proving your refugee status
* Certified copies are stamped as true copy of the original by a person authorised by law to take statutory declarations in your country. In New Zealand, this can be done by a Justice of the Peace, lawyer, notary public, court official or police officer. If you visit the College campus, we can take certified copies of your original documents for your application.
Do you live with the effects of significant injury, long term illness, neurodiversity, or disability?
The information you supply is confidential.
Have you ever been convicted of a criminal offence?
Do you currently have any court cases or legal proceedings pending against your name??
Contact Details

Education Record

Name of School Country Year started Qualification Year completed
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(University, Technical College, Other)
Name of School Country Year started Qualification Year completed
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English Proficiency
Academic Integrity
a) have you had any academic issues
b) have you had a complaint against you by a student or an academic institution?
c) have you been accused of or charged with dishonesty during an assessment?
Dishonesty during an assessment includes:
During an examination - copying, communicating or having unauthorised material;
During assessed work - plagiarism, unauthorised collaboration or submitting similar work for more than one assessment.

Chiropractic Care

If you have been under care or observed a chiropractor, please list details below
Approximate Date Chiropractor Name Observing / Under Care
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Chiropractic Referral

If a Chiropractor has encouraged you to become a student at the New Zealand College of Chiropractic, please attach a letter of recommendation from them.

Personal Statement

The New Zealand College of Chiropractic would like to know more about you.
Please submit a 250 word statement. Tell us about yourself and explain why you want to be a Chiropractor. Your statement should be grammatically correct, clear and easy to read.
General Information

Finalise Application

Privacy Act

The information collected by the New Zealand College of Chiropractic during the admissions and enrolment process and during the period in which the student is enrolled at the College is intended for use in connection with assessing the suitability of the applicant and the subsequent education while at the College. The College has, as its primary purpose, the provision of academic education of students and shall obtain such information as necessary to achieve this purpose. The information collected may be used by any of the staff at the College. Applicants have the right to access and request correction of any personal information collected by the College.

Student Handbook

All College policies are available in the Student Handbook found on our website at chiropractic.ac.nz.
You are advised to review the handbook prior to submitting your application to understand your rights and obligations.

Application Fee $0
Declaration and Signature

I declare that the information I have supplied on this form and any attached documentation to be true and complete and I acknowledge that the New Zealand College of Chiropractic may suspend my enrolment if false information has been suibmitted or required information is not provided by the due date. I acknowledge that I have been advised of the policies in the student handbook and the Privacy Act.

I understand that there is no obligation for the College to offer me enrolment.

 

Please use the area below to sign your application. *