Conviction Form for 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.
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Your name (*): |
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Name of court (*): |
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Your phone number (*): |
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Your email address (*): |
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The teacher's full name (*): |
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The teacher's date of birth (*): |
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The teacher's last known address (*): |
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Details of the offence(s) of which the teacher was convicted (*):
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Plea entered(Guilty or Not Guilty): |
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Date of conviction: |
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Sentence imposed: |
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Did the court make a permanent |
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Enter any other information that you consider will assist the Complaints Assessment Committee in its investigation of the conviction:
Signed(*):
Date(*):