Application form – Apply for additional test results

Your contact details

Title

First name*

Enter your legal first name or given name, as shown on your national identity document or passport

Middle name(s)

Enter your middle name(s), as shown on your national identity document or passport

Last name*

Enter your last or family name, as shown on your national identity document or passport

Date of birth (select day, month, year)*

Passport number

Please enter your passport number. We use this to find you on our partner site for registration.

Phone number*

Enter the number for the phone you use most often.

Email*

Enter your email address in format: yourname@example.com

Address

Unit, Building name

Enter the unit and/or building name if relevant, like 'Flat 1, Acme House'

Street address*

Enter your street address, like '128 Valley Road East'

Suburb

RD number

Enter a rural delivery number if relevant

City, town or locality*

Postal code or ZIP number

Country*

Test details

Candidate number*

Enter your candidate number.

Date of test (select day, month, year)*

Test location*

Enter the location where you took your test

Address to send your results

Please give details below of where you would like your results sent to

Name or department

Enter the person or department you want us to send your results to

College, university or organisation

Unit, Building name

Enter the unit and/or building name if relevant, like 'Flat 1, Acme House'

Street address

Enter your street address, like '128 Valley Road East'

Suburb

RD number

Enter a rural delivery number if relevant

City, town or locality

Postal code or ZIP number

Country

Do you wish to enter a second address?

Yes No

Address to send your results

Please give details below of where you would like your results sent to

Name or department

Enter the person or department you want us to send your results to

College, university or organisation

Unit, Building name

Enter the unit and/or building name if relevant, like 'Flat 1, Acme House'

Street address

Enter your street address, like '128 Valley Road East'

Suburb

RD number

Enter a rural delivery number if relevant

City, town or locality

Postal code or ZIP number

Country

Privacy Disclosure Statement

This information is being collected to help to find you on our partner site for registration and as strictly necessary only, to meet our other Purposes and Legitimate Interests set out in our Privacy Statement. We may be unable to process your request if you choose not to supply any information noted as mandatory. Your information will be held securely and processed in accordance with our Privacy Statement. If you would like to access or correct your information please contact us at privacy.officer@massey.ac.nz. If you are submitting this form from the European Union or United Kingdom, please also note the additional information relevant to you in our Privacy Statement.