electronic (DOC, 85KB)

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
Complete all sections of this form electronically by typing in the gray boxes. Use the Tab key to move through
the document
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
If you email this, you do not need to also complete and mail the written form you received
It is a good idea to keep a copy of this form
Candidate Name:
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.
Contact phone number
Preferred email address