ECAN – Complete Learner Enrolment Details and Training Agreement

NZQA require the below information be collected in order to have Skills Standards, Unit Standards, or other relevant qualifications registered.
If you have already booked on an upcoming workshop please complete the form below.

Please provide your own personal email address, phone number and home address. These details are used to contact you directly regarding your enrolment, assessment, results, certification and NZQA reporting matters.

– Step 1 of 4

Please read before filling in this form:

⚠️ Important: You must complete FOUR steps to finish!

STEP ONE: Select – I confirm I have read and understood the below Privacy Statement and Learner Declaration

STEP TWO: Fill in and sign the Work-Based Training Agreement box inside this form. Submit and DO NOT close this form.

STEP THREE: Complete your personal enrolment details in the form below.

STEP FOUR: Click the Submit button at the very bottom.

📌 Note: If you do not sign the agreement AND click Submit, your enrolment is not complete.

STEP 1 OF 4: Privacy Statement and Learner Declaration

Privacy Statement and Learner Declaration *

• I confirm I have read and understood the below Privacy Statement and Learner Declaration

By completing and submitting this form you declare that the information provided is true and correct and consent to NGTC 2018 Limited and Trilogy Training Ltd collecting and using this information for enrolment, assessment, certification and NZQA reporting purposes. The information collected in this form will be managed in accordance with the Privacy Act 2020.

⚠️STEP 2 OF 4: Sign Work-Based Training Agreement

✍️ Sign the Training Agreement Fill out and sign the agreement box below. Click the Submit / Sign button inside this box. 🛑 DO NOT CLOSE THE PAGE YET! Scroll down to complete Step 2.

I confirm I have submitted the Training Agreement and have a received a copy via email *

• Yes, email received

⚠️STEP 3 OF 4: Complete learner enrolment details

1. Workshop Details

Qualification / Unit Standard / Skill Standard

Workshop Date/s

For 2 day workshops, please select the start date

Workshop Location

Town/City

Employer (If applicable)

Company name

Position

Contact Person Name and Phone Number

Who is paying for the training?

• Myself (individual)
• My employer

For invoicing purposes

Next

2. Personal Details

Title *— Select Choice —MrMrsMissMsMasterOther

Please specify *

e.g. Dr, Prof, etc.

Full Legal Name *

First

Middle

Last

Preferred Name

Date of Birth *

DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Gender *— Select Choice —MaleFemaleGender DiversePrefer not to answer

National Student Number (NSN) *

If you do not have an NSN yet please type TBC, one will be created for you. Please upload a copy of your Birth Certificate or Passport below. Note: Primary ID is required to create an NSN, Drivers Licenses are not able to be used for this purpose.

To find your NSN click here

Identification Upload

Drag & Drop Files, Choose Files to Upload

Please upload a copy of your identification. If you have an NSN: Please provide a copy of your Driver’s License, Passport, Birth Certificate, or Kiwi Access Card. If you DO NOT have an NSN: You MUST provide a copy of your Birth Certificate or Passport to verify your identity. Please ensure your file is clear and readable.

Next

3. Contact Details

Reminder: Please ensure you provide your own personal contact information (not your company or employers details).

Personal Email Address *

Mobile Number *

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Next

4. Citizenship / Residency

Country of Birth *— Select Choice —New ZealandAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State ofBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d’IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People’s Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlands, Kingdom of theNew CaledoniaNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States of AmericaUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabwe

If born outside of NZ, year first arrived in NZ:

Citizenship/Residency *— Select Choice —NZ CitizenNZ Permanent ResidentNZ Work VisaStudent VisaAustralian CitizenOther

Please specify *

Ethnicity (Optional)

• NZ European / Pākehā
• Māori
• Samoan
• Cook Island Māori
• Tongan
• Niuean
• Chinese
• Indian
• Other

Please specify

Iwi (Optional)

⚠️ STEP 4 OF 4: Final Check & Submit Before you click the button below, check: If YES, click the button below to finish your enrolment! *

• I have signed and submitted the training agreement above
• I have completed my personal details above

Learner Privacy filling

Submit