Student Enrolment Application
BLUE FIELDS ARE MANDATORY

Details  
 
Gender
Title
First Name
Middle Name
Surname
Email Address
Date of Birth
Nationality
Country of Birth
Are you an Australian Citizen ? Yes
Are you an International Student ?
(i.e. Have come from another country to study in Australia)		 Yes
Are you Living in Australia ? Yes
Are you an Australian Resident ? Yes
 
Address in Australia  
Address
 
 
Suburb/City
State
Post Code
Country
 
Mailing Address  Copy Address
Address
 
 
Suburb/City
State
Post Code
Country
Phone # (Please put a + symbol before international phone #'s)   Mask  ((xx) xxxx xxxx)
Fax #   Mask  ((xx) xxxx xxxx)
Mobile #   Mask  (xxxx xxx xxx)
Overseas Details  
 
Do you currently hold an Australian Visa? Yes
Do you have a Student Visa? Yes
Do you want us to organize Overseas Health Cover for you? Yes
Visa Type
Expiry Date
Passport #
   
Home Country Address  
Address
 
 
Suburb/City
State
Post Code
Country
Student Services  
 
Will you require Homestay? Yes
Airport Transfer Required? Yes
Educational Background  
 
Have you completed any Secondary School Studies: Yes
Do you wish to apply for Recognition of Prior Learning or Credit Transfer? Yes
Educational Background
English Language Proficiency  
How would you describe your English?  
Listening/Speaking:
Reading/Writing:
Have you undertaken a recognised English Language test in the last two years? Yes
Health Details  
Do you have any special needs or require any adjustments to accommodate you in your course? Yes
(You may wish to discuss this confidentially with your lecturer at orientation.)  
So that we can accommodate you in the workplace and in your training, do you suffer any allergies or medical problems? Yes
Cultural  
Non-English Speaking Background  
Do you speak a language other than English at home? Yes
Do you have any special cultural requirements? Yes
Agent Details  
Do you have an Agent? Yes
Course Details  
Course
Preferred Start Date
End Date
Study Weeks
Holiday Weeks
Total Enrolment Duration
Declaration  
 
I declare that the information provided by me on this application form is true and correct, and that it relates specifically and solely to me as an individual. I accept that Academia International makes decisions based on this information and may seek further information or clarification as required. I understand that if offered a place in a course of training I will be required to pay fees and meet requirements specific to that course before my enrolment is confirmed. I accept that failure to attend the scheduled sessions may compromise my ability to satisfy some or all of the course requirements. I further accept that additional training may be required if I do not meet the course requirements, that this training is at an additional cost to myself and that any requirement to undertake this extra training is at the discretion of Academia International.

Academia International reserves the right in its absolute discretion to reject any application for enrolment, and it shall be under no obligation what soever to give reasons for its decision. Enrolments at Academia International must be completed prior to the commencement date of the program/courses and a non-refundable fee must be paid to secure the enrolment. Academia International does not accept students who have not enrolled prior to the commencement of programs or courses.

I also give Academia International permission to contact me by email.

I understand that the ‘Agreed start date’ will be listed on my Letter of Offer and may not necessarily match the date recorded on this application. I understand that the compulsory induction and orientation program will be conducted on the Agreed Course Start Date.
Click the 'Yes' box if you agree to the above terms and conditions Yes