Degree ApplicationBachelor of Medicine, Bachelor of Surgery (MB ChB)

University of AucklandTo access ISA Degree services please submit your university application directly to our office. From start to finish, we provide you FREE support and enrollment assistance while you seek your degree in any field of study. We are here for you on behalf of the universities as your main contact in North America.Please adjust your filters in your preferred email account to allow all emails from ISA into your inbox. All updates and information about your application(s) will be emailed, so we want to make certain you receive our emails!

Please note: International applicants must first complete first year courses in either the Bachelor of Health Sciences or the Bach-elor of Science at the University of Auckland. There is no guarantee of entry into the MBChB after completion of the first year.

The University of Auckland Bachelor of Health Sciences or the Bachelor of Science will begin in February 2016.

Applications for February 2016 are open. The application deadline for the 2016 intake is November 1, 2015 (New Zealand time)

APPLICATION TIMELINE

APPLICATION INSTRUCTIONS1. Fill out the following university application form.2. Return the signed and dated application directly to ISA

At no point will you need to send anything to New Zealand! ISA will submit your completed application for you.International Studies Abroad

Attn: Degree Programs12050 N. Pecos Street Suite 320 Westminster, CO 80234 USA

We will also accept legible scanned copies of the application. Please email degrees@studiesabroad.com to email your application to your ISA Program Manager.

3. Save or print a copy of the application for your records.Application Materials:

Official Transcripts SAT or ACT scores (US Students Only) Notarized copy of passport Passport picture UMAT scores (Graduate Entry only)

Application fee is WAIVED (must apply through ISA).

IMPORTANT INFORMATIONOnce we receive and process your application(s), you will receive an email. Please check your email regularly for communica-tion from your ISA Program Manager. We will also provide you access to your ISA MyLearn account, which will be your student portal. Your MyLearn account will keep you updated on your application status, and once you have received an offer you will have a To Do List and Participant Guide to assist you with completion of all pre-departure procedures and processes.

If you have any questions as you are working on your application(s) please contact the ISA Program Manager at degrees@studiesabroad.com or Toll Free at 1.800.980.0033.

SECTION A - Personal DataHave you been given an ID number by The University of Auckland?

Yes ID number (If known):

No

Attach a recent professional

colour passport size photo

here. Please use paperclip, DO NOT glue

or staple.

THE UNIVERSITY OF AUCKLANDAPPLICATION FOR ADMISSION

Please print in CAPITAL LETTERS or mark boxes with a cross eg X , using a black or dark blue pen. Please DO NOT fold this form. DO NOT submit more than one Application for Admission. Return this form, along with any required documentation, in the prepaid envelope provided, or post to: The University of Auckland, P.O. Box 91346, Auckland.For information on closing dates, Programme and Campus codes, and supporting information refer to the Information Sheet or www.auckland.ac.nz/admission

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OFFICE USE ONLYApplication ReceivedKeyedScannedAUNAKLAPPL/SEP 05

Gender Male FemaleX XEmergency Contact Information

Emergency Contact Name:

Relationship:

Phone Number:

1. Mailing address

City

Country

Post Code Telephone

Any University correspondence will be posted to your mailing address

2. Permanent home address

(if different from above)

City

Country

Post Code Telephone

3. Work address (if relevant)

City

Country

Post Code Telephone

Proposed year of enrolment 20

Y

4. Email address

5. Fax number 6. Mobile Number

Y Y

X Mr Mrs Ms Miss Other (please state)X X XPersonal Details

Title

Legal Family name

Legal First name(s)

Preferred name

Previous name (if applicable)

Date of birth D D M M Y Y

Extn

X

Please print in CAPITAL LETTERS or mark boxes with a cross eg X , using a black or dark blue pen. Please DO NOT fold this form. DO NOT submit more than one Application for Admission. Mail this form along with any required documentation to: GlobaLinks Learning Abroad 12050 N. Pecos St, Suite 320 Westminster, Colorado 80234 USA

SECTION B - Proposed Programme(s)Please indicate, in order of preference, the programme(s) for which you are applying using the programme code from the Information Sheet or www.auckland.ac.nz/admission. If you are applying for a double degree or more than one programme, put each programme code as a separate choice. If you are applying for a conjoint programme use a single conjoint code. Add the campus code and term code (from the Information Sheet) and your major, minor or specialization if applicable.

1.

2.

3.

4.

Programme Code Minor Campus Plan (Major, Minor or Specialization) Major/

Spec Term Code

Postgraduate only - Research area of interest

Proposed Supervisor

SECTION C - Additional Selection CriteriaThere is an overall limitation on admissions in some faculties. However, consistent with Equal Educational Opportunity provisions, there are also entry schemes for some groups. Please mark the appropriate box and fill in any additional forms required by the Faculty to which you are applying (refer to the Faculty website or the Information Sheet).

Maori student resident in New Zealand Mature student resident in New Zealand

Pacific Island student resident in New Zealand Student with a disability resident in New Zealand

Rural student resident in New Zealand

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XXX

SECTION D - Admission Qualifications1. Tertiary EducationIt is a requirement of The University of Auckland that you declare all tertiary level education (Polytechnic, University, College of Education etc.) previously undertaken. PLEASE NOTE: You must attach a verified copy of your official academic transcripts with subjects undertaken and results. If your transcript is in a language other than English, you must provide both the original version and an English translation.

a. Have you ever attended a tertiary institution? Yes No (go to Question 2 - Secondary Education)

b. Was your most recent study undertaken at The University of Auckland? Yes (go to Section E -- Statistical Data) No

c. What was your first year of study at any tertiary institution?

d. Please list all tertiary qualifications you have gained or attempted.

FromYear

To Year Name of Institution Country Qualifications

Completed(Y/N)

e. Do you wish to apply for credit? Yes NoX X

X XX XX XX XX XX XX XX X

X

X

Y Y Y Y

2. Secondary EducationIt is a requirement of The University of Auckland that you declare all Secondary level education previously undertaken. PLEASE NOTE: If your highest qualification is from a secondary school, you must attach a verified copy of your official school results. If your transcript is in a language other than English, you must provide both the original and an official English translation.

a. Last secondary school attended:

OR Last overseas school attended:

b. Final year of attendance at secondary school: Y Y Y Y

There are non-refundable application fees for credit assessment and assessment of overseas qualifications. See Section F for details.

X

X

XNo formal school qualification/ NZ A or B Bursary/0 - 11 NCEA level 1 credits NZ University Entrance 80+ NCEA level 3 credits

NZ School Certificate (one or more subjects/ NZ Higher School Certificate/ 12+ NCEA level 1 credits 0 - 41 NCEA level 3 credits NZ Scholarship

NZ Sixth Form Certificate (one or more subjects/ NZ Entrance Qualifications from Bursary Exam/ 12+ NCEA level 2 credits 42 - 79 NCEA level 3 credits Other - please specify below

Overseas qualification Please specify:

d. Please indicate which of the following qualifications you are studying or have studied, under:

National Certificate of Educational Achievement (NCEA) Level 3 Bursary (NZUEBS)

Cambridge International Examinations sat in New Zealand International Baccalaureate sat in New Zealand

e. If you have qualified, or are attempting to qualify, for one or more of the above qualifications sat in New Zealand, please enter the details below.

Year National Student Number/(Candidate Code)

Year National Student Number/(Candidate Code)

Year National Student Number/(Candidate Code)

Year National Student Number/(Candidate Code)

f. Last foundation school attended:

Y Y Y YY Y Y Y

Y Y Y YY Y Y Y

4. English Language Proficiency

a. What is your first language? English - Go to Section E

Maori - Go to Section E

Pasifika - Please Specify

Other - Please Specify

b. Have the last two years of your education been conducted in English? Yes - Go to Section E No

c. Have you sat an IELTS (Academic), TWE, or TOEFL test? Yes - indicate result below No - go to Section E

XXXX

X XX X

IELTS (Academic) result achieved Year result obtained

TOEFL result achieved TWE Year result obtained

You must attach a verified copy of your result. Note: you may be required to take an English Proficiency test.

Y Y Y YY Y Y Y

SECTION E - Statistical Data

1. Citizenship

New Zealand Citizen - go to question 4 Australian Citizen - go to question 4 New Zealand Permanent Resident Australian Permanent Resident International Student

The information collected in this section is for statistical use by the Ministry of Education and The University of Auckland. It will not be possible to identify any individual whose information has been used to produce those statistics. Your answers will not affect your entry to the University or to a particular programme.

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New Zealand and Australian Citizens must provide a verified copy of their Passport, Birth Certificate or Certificate of Citizenship. New Zealand and Australian Permanent Residents must provide a verified copy of the front page of their Passport and the appropriate visas/permits. International students must provide a verified copy of the front page of their Passport or Birth Certificate. Students who have enrolled at The University of Auckland since 1990 are not required to provide name, date of birth and citizenship evidence unless their name or citizenship status has changed.

2. Origin If you are a Permanent Resident or International Student, please state the country which issued your passport.

Country

3. Agent If you are an International Student, are you using an Agent? Yes No

XX X

Country:

XX

XX

c. Highest completed academic secondary school qualification:

3. Provisional/Discretionary Entrance or Special Admission (Applies to New Zealand & Australian Citizens & Permanent Residents only.)If you do not hold (and are not sitting for) a university entrance qualification (or equivalent) from either New Zealand or overseas, you must apply for either Provisional or Discretionary Entrance (if you are aged under 20) or Special Admission (if you are aged 20 or over). Please mark the appropriate box. If you qualify for one of these categories an additional form will be sent to you.

Provisional Entrance Discretionary Entrance Special AdmissionX X XThere is a non-refundable application fee for Provisional/Discretionary Entrance and Special Admission. See Section F for details.

X X

X

X

X

X

X

X

X

X

X

4. Ethnic GroupTo which ethnic group(s) do you belong? Maximum of three.

New Zealand Maori

Iwi

XXXXXX

XXXXXX

X

6. IRD Number If you have a New Zealand IRD number, please state - -

7. DisabilitiesDo you live with the effects of an injury, long term illness or disability? Yes No

Do you need some form of assistance from the Disability Services? Yes No

XX

XX

8. Highest Qualification What is the single highest qualification held by your parents or caregivers?

SECTION F - Application Fees (Applies to New Zealand & Australian Citizens & Permanent Residents only.) Please read this section to find out whether you need to pay a fee with this Application for Admission. If your highest qualification (gained or attempted) is from an overseas secondary school (including International Baccalaureate) please include NZ$75 If your highest qualification (gained or attempted) is from an overseas tertiary institution please include NZ$125 If you are applying for academic credit for study carried out at another New Zealand tertiary institution please include NZ$75 If you are applying under the Provisional Entrance, Discretionary Entrance, or Special Admission categories please include NZ$50

Payment Details (Application fees are charged on submission of an application and are non-refundable).I enclose payment of: NZ$50 NZ$75 NZ$125

in the form of: Mastercard VISA Cheque (payable to The University of Auckland)

Card number Expiry date

Cardholder name

Receipt required Yes No

5. Previous OccupationWhat was your main activity or occupation in New Zealand as at 01 October in the year before your intended enrolment?

Secondary School student Polytechnic student House-person or retired

University student Waananga student Unemployed or other beneficiary

College of Education student Wage or salary earner Overseas (irrespective of occupation)

Private Training Establishment student Self-employed

XX

XX

M M Y Y

X X

Section G - InformationHow did you find out about The University of Auckland?

PLEASE NOTE: A verified document is a photocopy of the original endorsed with the statement Original sighted. Certified true copy by a person authorised to sign a Statutory Declaration, such as a Justice of the Peace, Solicitor or a duly authorised staff member of The University of Auckland.

Need help?If you have any queries concerning your application, please contact us:Student Hotline: 0800 61 62 63 (or on +64 9 308 2386 for calls from outside New Zealand) Address: Student Information Centre, The ClockTower, The University of Auckland, 22 Princes Street, AucklandEmail: studentinfo@auckland.ac.nz

Declaration (All students must sign)I promise to abide by the Statutes and Regulations, and comply with the reasonable requirements of The University of Auckland as published in the University Calendar. I declare that the information set out in this application form and attached documents is complete and correct and I acknowledge that the University may cancel my enrolment if false information has been supplied or if information required is not supplied by the due date. I have read and understood the outline of how the Privacy Act 1993 will be applied to the information I supply and I authorise The University to collect, use and disclose personal information about me in accordance with that outline and the Privacy Act 1993. I understand that if I apply for a Student Allowance or a Student Loan, the University may disclose relevant personal information to StudyLink for the administration of those schemes. I authorise The University of Auckland to make amendments to my proposed study where such amendments are necessary to comply with degree regulations and requirements. I authorise any agency holding the source of information I have provided on this form to release that information to the University on request.

European/Pakeha or NZ European Samoan

Cook Island Maori Chinese

Other Pacific Island Tokelauan

Other Asian Fijian

Tongan Indian

Niuean Other

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XXXX

XXX

Signature DateM M Y YDD

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Waived for students applying through GlobaLinks Learning Abroad

DegreeApplicationsOzNZ2012UAUCKUGandPG.pdfUAUCKUGandPG.pdfDegreeApplicationsOzNZ2012UAUCKUGandPG.pdf