Grandfathering Pathway

Personal Details

Name*

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Address

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Phone

Email

Position

Organisation

Employment Address

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Work Phone

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Current Accreditation

Accreditation Level*

Please tick the LEVEL(s) you are applying for accreditation in:

Speciality Details

Please tick your primary, and if applicable secondary speciality areas that you have acquired hours for level 2

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Qualification

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Institution

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First Aid and CPR certificates

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I declare the information I have provided in support of this application is a true and correct reflection of my qualifications, education and experiences. I agree to abide by the SESNZ Code of Ethics.

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Privacy Policy*

I consent to the collection of my contact address and personal details by Sport and Exercise Science New Zealand for the purposes of assisting the development of Sport and Exercise Science New Zealand and for it to retain, use and disclose this information to its officers and members for this purpose. I acknowledge my right to have access to and correct this information under the Privacy Act 1993.