HIGHER EDUCATION STUDENT APPLICATION FORM (International Student Only) SECTION A: PERSONAL DETAILS Name*TitleFirstLast Date of Birth*01020304050607080910111213141516171819202122232425262728293031day / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecembermonth / 202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901year USI* Nationality* Passport No.* Email* Phone No.* Current Address in Australia* Street Address City State Postal Address in Home CountrySECTION B: VISA / IMMIGRATIONDETAILS B1. Are you currently holding an Australian visa?*Yes (please go to B1-1)No B1-1. Visa Category number Visa Expiry Date B2. Do you intend to apply for a student visa?*Yes (please go to B2-1)No B2-1. DIBP office for lodgement B3. Have you applied for a student or any other visa to Australia in the past?*Yes (please go to B3-1)No B3-1. Was it granted?Yes (go to B3-1-1)No (go to B3-1-2) B3-1-1. If granted: why are you reapplying? B3-1-2. If refused: the reason for the refusal B4. Apart from Australia, have you applied for any student or other visa to US, UK, Canada or NZ?*Yes No B5. Was it granted in all cases?*Yes No If no, why? B6. Have you ever been convicted of a crime or offence?*Yes NoFamily Immigration details B7. Are you married?*YesNo If yes, please provide date of marriage* B8. Is your spouse currently employed?*YesNo B9. Will your spouse leave his/her job and join you as a dependant?*YesNo B10. Do you have child/children?* C1. Select Course*Diploma of Business (Higher Education)Bachelor of BusinessBachelor of Business (Professional Accounting)Bachelor of Interactive MediaGraduate Certificate in BusinessGraduate Diploma in BusinessMaster of BusinessGraduate Certificate in Professional AccountingGraduate Diploma in Professional AccountingMaster of Professional Accounting C2. Preferred Course Commencement Dates*MarchJulyNovember Year*Advanced Standing/Credit Transfer Are you seeking to apply for Advanced Standing/ Credit transfer for previous studies?*YesNo*Applicant must attach completed Application form of Advanced Standing and detailed syllabus or curriculum for Advanced Standing/ Credit to be assessed. This must include courser content, assessment mode, contact hours, prescribes text, etc. D1. Do you have a disability, impairment or long term medical condition which may affect your studies?*Yes (go to D1-1)No D1-1. If yes, please provide detailsENGLISH LANGUAGE PROFICIENCY E1. Is English your first language?*YesNo (go to E1-1) If no, what is your first language? E2. Your English Level*ElementaryPre-IntermediateIntermediateUpper IntermediateAdvanced E3. Have you taken a formal English test?*Yes (go to E3.1 - E3.3)No E3.1. Name of Test E3.2. DateE3.3. Score: Overall Listening Reading Writing Speaking Applicants must attach certified copies of English testing results.*PREVIOUS EDUCATION BACKGROUND AND QUALIFICATIONSE4. Current Studies E4.1. Name of qualification* E4.2. Name of Institute* E4.3. Country*AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCongo (Brazzaville)Costa RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWalesYemenZambiaZimbabwe E4.4. Date Completed* E4.5. Will you complete any studies prior to the commencement of your proposed WIN program?*YesNo E5. Completed Higher Education*High SchoolCollegeUniversityOther E5.1. Name of qualification* E5.2. Name of Institution* E5.3. Country*AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCongo (Brazzaville)Costa RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWalesYemenZambiaZimbabwe E5.4. Date Completed**Applicants must attach certified copies of all relevant academic certificates and transcripts. Certified copies must be stamped and signed by a JP or an approved WIN education agent, and the certifier’s stamp must include the certifier’s printed name, title/position, signature and date of notary. All documents not in English must be translated into English by an approved translator.WORK EXPERIENCEList details of your previous work experiences (Please attach all work reference letters)E6. Employment 1 Employer's Name(1) Position and type of work(1) Duration(1)E6. Employment 2 Employer's Name(2) Position and type of work(2) Duration(2) Applicants must attach certified copies of all relevant work references.SECTION F: DETAILS OF FUND ( Apply for New Student Visa Only)
