International Student Application Form

international
student
application form
Please return form to:
USC International
University of the Sunshine Coast—ML17
MAROOCHYDORE DC QLD 4558 AUSTRALIA
Fax: +61 7 5430 2836
Email: [email protected]
To complete this form:
• Answer all questions on the form—No application fee
• Use BLOCK LETTERS and tick check boxes where required
• Do not complete this form if you are an Australian/New Zealand citizen,
Australian Permanent Resident, or a Permanent Humanitarian visa holder.
Study Abroad applicants please use the Study Abroad Application Form.
Higher Degree by Research application information is available from the USC website
Email application Print and fax
www.usc.edu.au/internationalapply
1.0 Personal details
Have you been previously enrolled at the University of the Sunshine Coast? c No c Yes—Student ID number:
Title: Mr / Mrs / Miss / Ms / Dr / Other:
Date of birth:
Day
(as shown on passport)
Month
Given names:
Country of birth:
Citizenship:
Date of issue:
Sex: c Male c Female
(eg 21 / January / 1979)
Family name:
Passport number:
Year
DD / MM / YYYY
Country of issue:
What visa are you applying for? c Student visa c Extension to Student visa—subclass:
Do you need additional OSHC* for accompanying family members? (fees apply): c Yes c No
c Other:
Type of cover: c Dual family# c Multi family†
* Overseas Student Health Cover. # Either one adult spouse or recognised de-facto partner or one or more dependant children accompanying the valid Student visa holder.
† More than one dependant which can only include one adult spouse or recognised de-facto partner and one or more dependant children accompanying the valid Student visa holder.
Address / contact details
Number and street:
Town/City:
State:
Country:
Postcode/Zip:
Email:
@
Telephone: Country Area Local number
Mobile:
Fax: Country Area Local number
Permanent Address in home country (if different from above)
Number and street:
Town/City:
State:
Country:
Postcode/Zip:
Telephone: Country Area Local number
2.0 English language proficiency
c Yes—English is my first language (Evidence of first language may be requested) c No—my first language is:
If English is not your first language, please fill in the following and attach documentary evidence.
c English proficiency test taken (eg Cambridge, IELTS, TOEFL, DAAD):
Score:
c I intend to sit for an English proficiency test:
Date:
DD / MM / YYYY
Test date:
DD / MM / YYYY
c I applied for/am currently taking an English Language Program at USC.
c I have successfully completed a course delivered entirely in English, within the last five years, for:
c two years full-time secondary study c one year full-time University level study c one year full-time other post-secondary study
3.0 Program preferred
Preference
Name of degree program
Mode of Study
Semester or Trimester
1
c On campus c Online
Semester/Trimester:
2
c On campus c Online
Semester/Trimester:
3
c On campus c Online
Semester/Trimester:
Year
(eg Bachelor of Arts, Master of Professional Accounting)
INT004 | 0513
CRICOS Provider Number: 01595D
www.usc.edu.au/international | Page 1 of 2
international
student
application form
4.0 Previous and current secondary and post-secondary studies (eg High School, TAFE, University)
Institution / School
Name of Award / Qualification
Year completed
or year to be
completed
Language of
instruction
Country
Main fields of study
(If post-secondary study)
Previous studies
Current studies
Documentary evidence of previous and current studies must be attached including full academic transcripts (statement of results and award
certificates). Documents not in English must be accompanied by certified English translations.
Academic credit transfer: Do you want to claim credit? c No c Yes*
Would you prefer an offer even if the credit assessment has not been completed? c No c Yes
èIf you tick ‘No’, an offer will only be sent when the credit assessment has been completed.
èIf you tick ‘Yes’, you will receive an offer as soon as you are deemed eligible for program entry. Credit assessment advice will follow at a later date.
* To claim credit for your previous post-secondary studies (eg university, college, technical or vocational study), please attach a completed ‘Application for Credit’ form
available from the USC website www.usc.edu.au/internationalcredit and include full subject descriptions.
5.0 support services
Do you have a disability, impairment or long-term medical condition, which may affect your studies?
c No c Yes è c Hearing c Learning c Mobility c Vision c Medical c Other:
This information is used in a confidential manner by Student Life and Learning to assist you in accessing support services as required.
6.0 Declaration
checklist
I agree to pay all fees for which I am liable, and have read and agree to abide by the University of the Sunshine
Coast’s Student rules, policies, procedures and guidelines and conditions of enrolment, including the Student Fees
and Charges Policy, and Student Fees, Charges and Refunds Procedures, which are available on the USC website
www.usc.edu.au/international-student-rules
I consent to information collected about me on this form being disclosed if authorised or required by law, and/or
in certain circumstances the Australian Government and/or designated authorities authorised by the University,
in accordance with the University’s Privacy Plan available at www.usc.edu.au/privacyplan
I declare that the information I have provided on this application form is true and complete and authorise the
University of the Sunshine Coast to obtain further information required to complete enrolment.
I agree to immediately notify the University of the Sunshine Coast of any changes to the information I have given
in this application form, including a change of address.
I understand the University of the Sunshine Coast reserves the right to vary or reverse any decision regarding
admission or enrolment made on the basis of incorrect or incomplete information.
I understand that I cannot change my education provider during the first six months of my course, except in limited
circumstances, without a written letter of release from the University of the Sunshine Coast and an official offer
of a place from another registered education provider.
I agree that I am fully responsible for all education and living expenses, both for myself and for all my dependants
that accompany me while I am studying at the University of the Sunshine Coast, and am aware that school-aged
dependants accompanying me will be required to pay full fees at a private or government school in Australia.
I understand that my rights and responsibilities as a student studying in Australia are governed by the
Education Services for Overseas Students (ESOS) Act 2000 and the National Code 2007, outlined at
www.aei.gov.au/Regulatory-Information This agreement, and the availability of complaints and
appeals processes, does not remove my right to take action under Australia’s consumer protection laws.
Have you completed all sections of this
application form?
Have you attached certified copies of
English proficiency?
Have you attached certified/notarised
academic transcripts?
Have you attached employment history
details (where applicable)?
Have you attached certified/notarised
copies of graduation certificates?
Have you read and signed the
Declaration?
Have you attached certified/notarised
copies of official English translations of
any documents created in a language
other than English?
I heard about USC from:
home institution / agent details
c I understand and accept the conditions set out in the declaration above.
Name:
Date:
Email application Print and fax
INT004 | 0513
CRICOS Provider Number: 01595D
www.usc.edu.au/international | Page 2 of 2