Application to Graduate March 2015
Application to Graduate March 2015 Please complete and return this application form by 16 February 2015 to Whitireia New Zealand, Attn: Cashier, DX Box: SX33459, Porirua 5022 or email an electronic copy to [email protected] 1. Graduation ceremony I am applying to attend graduation on 19 March 2015 (diploma, degree and postgraduate programmes) Tick here if you are unable to attend a graduation ceremony. Your award will be posted to the address listed below after being conferred on 19 March 2015. 2. Applicant's details Student ID Surname First name/s Phonetic spelling (this will assist the name readers at the ceremony) Programme of study Faculty Contact details Street Address Town/City Telephone Postcode Mobile Email address Tick here if you would like to keep in touch with Whitireia in the future (Whitireia Alumni). Your name will be included in the 2015 Graduation handbook and could be listed with other graduates in the Dominion Post. Please contact us if you DO NOT wish your name to be included. 3. Seating requirements GRADUAND SEATING GUEST SEATING Graduands attending the ceremony will be allocated a seat alphabetically by programme. Please advise if you have any special seating requirements. Due to the size of our venue, we ask that you bring four guests. However, we will attempt to accommodate all requests. Please state how many seats you require and any seating requirements. Number of guests Signature Date Day Month Year Please complete page two of this form 4. Academic dress Graduands at diploma, degree and postgraduate level are required to wear academic dress to their graduation ceremony. We require your full height so we can order the correct gown size. If you are degree or postgraduate qualified, we also require your head circumference for the trencher. A height chart and tape measure are available at the cashier’s office in Information and Enrolment at our Porirua campus. WHAT YOU NEED TO WEAR Diploma: Degree: Postgraduate: gown, stole gown, trencher, hood gown, stole, trencher, hood* *Hood is optional. Trencher is only required if you are already degree qualified. If you gained your degree from another institution, it is your responsibility to order the appropriate hood if desired. ORDER Tick Gown Whitireia Hood Whitireia Stole Postgraduate Stole Trencher Measurement Full height in cm: N/A N/A N/A Head circumference in cm: Hire cost $30 $10 $10 $10 $20 Total payable Amount payable CONDITIONS OF HIRE • • • You are required to return academic dress in a good condition to Te Rauparaha Arena (upstairs) after the ceremony You will be charged for the value of any academic dress damaged or not returned, and you will also be liable for debt collection costs The cost of academic dress hire is not refundable from two weeks prior to the ceremony DECLARATION I have read, accept and agree to abide by the Conditions of Hire as stated above. Signature Date Day Month Year PAYMENT DETAILS Cheque Please make cheque payable to Whitireia Community Polytechnic Credit card Credit card number Expiry date Month Cardholder's name Direct credit Amount Year $ Cardholder’s signature Date of direct credit Please make payment to the following account and include the details in the box as reference Account Name: Whitireia Community Polytechnic Account Number: 12-3244-0004001-00 Particulars GRAD MARCH Code [Student ID] Reference 213071500 Please return your completed application form to the cashier’s office in the Information & Enrolment Centre at the Porirua campus. Alternatively, you can post it to Whitireia New Zealand, Attn: Cashier, DX Box: SX33459, Porirua 5022 or email an electronic copy to [email protected]
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