This form relates to the 2015 Assessment and Examination rules and Procedures for Secondary Schools Sections 7.1.3 and 7.1.4
Breaches Reply Form
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Complete all sections of this form electronically by typing in the gray boxes. Use the Tab key to move through
the document
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Save a copy and email this to breaches@nzqa.govt.nz as an attachment. Put your name and NSN as the
subject of the email
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If you email this, you do not need to also complete and mail the written form you received
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It is a good idea to keep a copy of this form
Candidate Name:
NSN:
Subject:
Level:
I have read the report NZQA received about a possible Breach of the Rules.
I agree with this report (write yes or no in the box)
My explanation of what happened is:
I would also like NZQA to take into account
I confirm that the information given above is my reply to NZQA’s letter about a reported possible breach.
Name
Contact phone number
Preferred email address
Date