Termination of enrolment of foreign national holding a student visa

Use this form to notify Immigration New Zealand when terminating the enrolment of a foreign national holding a student visa. Please do not use this form if students have completed or graduated from their course.

Details of student
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Use this form for the following areas:
Date enrolment terminated
Surname*
First names*
Date of birth
Nationality
Passport number
INZ client number (if known)
Last known NZ address
Education provider
Name of education provider
Address/campus of education provider
Contact staff member
Contact phone number
Contact Email*

Intended course dates	From: To:
Course of study
Date of last attendance
Attendance during the last course of study (percentage)
Reason for termination	Poor attendance Non attendance (did not start, has never attended) Expelled (behaviour problems etc) Date of board disciplinary hearing: Student withdrew before course completion (if reason known, detail below)
Please provide any relevant comments

Immigration New Zealand appreciates you providing this information. The matter will be investigated and action taken where appropriate – however please note that under the provisions of the Privacy Act 1993, it is unlikely that advice can be given on the outcome of the investigation.