| Details of Applicant |
| Family Name: |
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| Given Name : |
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| Additional Names : |
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| Date of Birth : |
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| Age : |
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| Sex : |
Male
Female |
| Nationality : |
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| Language Spoken : |
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| Address |
| Email Address : |
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| Postal Address : |
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| Address (continued) : |
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| Address (continued) : |
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| City : |
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| State : |
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| Postcode : |
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Country :
(if other than Australia) |
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| Daytime Phone : |
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| Fax : |
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| Address in Australia (if known) : |
| Postal Address : |
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| Address (continued) : |
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| Address (continued : ) |
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| City : |
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| State : |
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| Postcode : |
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| Daytime Phone : |
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| Fax : |
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| Course |
| Course Applied for : |
General English
Part-time General English
Superlink Program
Cambridge Preparation Program
English for Further Study
Business English
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| Number of weeks : |
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| How did you hear about the college and its courses? |
Agent
Friends / Relatives
Advertisement
Exhibition / Seminars
IDP
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| Other : |
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| Educational Background |
| Name of Highest Qualification : |
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| Name of Institution : |
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| Year Completed : |
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English Language Proficiency score :
(i.e. TOEFL, IELTS, others) |
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| Self-Score |
Elementary
Pre-Intermediate
Intermediate
Upper Intermediate
Advanced |
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| Further Study in Australia |
| What will you do when you finish this course? |
High School
University Course
Business or other Vocational Course
Travel
Return Home
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| Other : |
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| If you are going on to further study: |
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| Course Applied for : |
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| Name of Institution : |
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| Course Commencement Date : |
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| Course Start Dates |
| Course Start Date : |
(Any Monday except Public Holidays)
Cambridge, EFS and Business have specific start dates |
Public Holidays 2008 |
| 1st January - New Years Day |
| 28th January - Australia Day |
| 10th March - Labour Day |
| 21 March - Good Friday |
| 24 March - Easter Monday |
| 25th April - ANZAC Day |
| 9th June - Queen's Birthday |
| 4th November - Melbourne Cup Day |
| 25th December - Christmas Day |
26th Decemeber - Boxing Day Holiday
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| Airport Pickup and Accommodation |
| Do you wish to be met at the Airport? |
Yes
No
Please provide details by fax as soon as possible |
| Do you require accommodation service? |
Yes
No
If yes, further information will be sent to you
to establish the right family for you. |
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| Visa Type |
Health Cover Fee (OSHC)
If you are travelling on a Student Visa the Australian Government requires you to pay Overseas Student Health Cover (OSHC) in advance to the College:
- 0 to 3 months — up to $93
- 3 to 6 months — up to $185
- 6 to 9 months — up to $278
- 9 to 12 months — up to $370
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| Select the Visa you will travel to Australia on, or are currently holding: |
Student
Visitor (tourist)
Working Holiday |
| Other : |
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| Fees (please complete) |
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| Enrolment Fee |
$
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| Tuition Fee |
$
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| OSHC |
$
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| Airport Pickup |
$
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| Accommodation Placement |
$
|
| Accommodation |
$
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| Other |
$
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| TOTAL |
$
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| Any other comments or enquiries |
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I have read and agree to the Terms & Conditions and Refund Policy
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