aPPlication form
1. Personal details
(as in passport)
Family Name:
Given Name:
Other Names
(i.e. your English name, if any):
Birthday
(DD/MM/YEAR):
Country of Birth:
Nationality:
Passport No.:
Male
Female
Have you been granted a scholarship? Yes
No
Scholarship’s Name or Sponsor’s Name:
Please attach a copy of the frst page of your passport which shows your photograph.
Will you be under 18 on arrival? Yes
No
*Please note: if you are under 18 years of age on commencement of study, certain visa regulations apply.
Are you a citizen or permanent/temporary resident of Australia?
Yes
No
What type of visa will you be applying for?
Student
Student Dependant
Tourist
Working Holiday
2. citizenship
3. student home/Postal address
(must be student’s address, not agents address)
4. english Programs
5. english language test scores
If you ticked a box with an asterisk (*), you will need Overseas Student Health Cover (OSHC). This can be arranged by UNSW Institute of Languages in section 8.
Address in Home Country (compulsory):
Address in Australia:
City:
Telephone:
Fax:
Email:
State:
Postcode:
Country:
City:
Telephone:
Fax:
Email:
State:
Postcode:
Country:
Student Address in Australia (if known)
Academic English
If you have taken an IELTS or TOEFL or other test, please give details and attach a copy of the test result if available.
Test must have been taken within 12 months of the enrolment date.
General English (GE)
Professional English
Term and start date? (see page 31)
Introduction to Academic English (IAE)
Academic English
Tertiary Orientation Program (TOP)
IELTS Test Preparation (ITP)
Pre-Foundation Year English (PFY)
University English Entry (UEEC)
General English (Beginner to Advanced)
GE Cambridge Exam Preparation
English for Business Communication (int & adv)
English for Law
English for Medical Professionals
How many weeks do you intend to study English?
Number of weeks (in 5 week blocks)
IELTS
Score (Overall):
IELTS Writing Score:
IELTS Test Report Form No.:
Cambridge Score:
TOEFL/IBT/PBT
Score:
PTE
Score:
UNI5601_UNSWIL Guide 2013_AW.indd 35
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