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FORM FOR REPORTING CONVICTIONS (REGISTRARS)

This form is for reporting to the NZ Teachers Council if a person whom you believe to be a teacher is convicted in your court of an offence carrying a maximum penalty of three months imprisonment or more. You should send it as soon as possible after the conviction is entered. Do not send a report if the court has expressly ordered you not to. Fields marked with an asterisk (*) are required.

Your name (*):
Name of court (*):
Your phone number (*):
Your email address (*):
The teacher's full name (*):
The teacher's date of birth (*):
The teacher's last known address (*):

Details of the offence(s) of which the teacher was convicted (*):

Plea entered(Guilty or Not Guilty):
Date of conviction:
Sentence imposed:
Did the court make a permanent order for name suppression?:

Enter any other information that you consider will assist
the Complaints Assessment Committee in its investigation of your conviction

If you wish to retain a printed copy of this form, select the print
function from your browser before clicking on the Submit button.
You will receive an automated email confirmation of receipt of your form if you provide a valid email address.

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