Learner Enrolment Form

WARNING!

Changing field labels and selectable answers WILL require changes to the webhook that processes this form's submissions.

IMPORTANT!

Some fields are hidden because:

-they are conditional on another questions answer eg. Other type fields

- others are hidden becuase they are no longer in use but have been retained to preserve historic data plus to allow the fields to be re-enabled in the future
First Name*
Middle Name(s)
Last Name*
Business Name
If applicable
Maiden Name
If applicable
Gender

FemaleMaleOther
Your Date Of Birth*

ddmmyyyy
Email Address*
example@example.com
Contact Phone Number*

Area CodePhone Number
Sorry, GetLCQ is restricted to New Zealand residents only.

IMPORTANT If you are a New Zealand resident and using a Virtual Private Network (VPN) to connect to the Internet, please turn off the VPN and try again. If you continue to see this message then please contact us.
Street name and number / PO Box*
Residential address only
Suburb
City*
Region*
Post Code
Ethnicity*

NZ EuropeanMaoriPacific IslanderIndianAsianOther
Is English your first language

NoYes
Hello! We noticed that English is not your first language. This is a level 4 course and requires a fairly high understanding of the English language.

We recommend you visit the IELTS website below and take a practice test to make sure you will be able to understand the information in the course. If you think you will need to improve your English skills, please ask IELTS for help options. To speak to one of our support team members please call 0800 800 415

IELTS HOME OF THE ENGLISH LANGUAGE TEST

IELTS is the high stakes English test for international study, migration and work. Open a world of opportunity with IELTS.

Read more >
NZQA Number
If known
What is your highest form of education in English?*
Do you have any learning difficulties?

NoYes
Please give details of your learning difficulties
Do you need any assistance or help?

NoYes

Payment:

Online course

Includes a digital certificate emailed to you.

$160.00NZD

Hardcopy certificate (optional)

Physical certificate mailed to your postal address

$20.00NZD

Total

$0.00NZD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Learner Handbook

To sit the LCQ test online you must read our learner handbook here (opens in popup). You also agree to receiving occasional promotional emails and surveys from GetLCQ and its affiliates.
Terms and Conditions*

I have read and agree to the terms and conditions as stated in the learner handbook
Should be Empty:

WARNING!

Sorry, GetLCQ is restricted to New Zealand residents only.