Student Form STUDENT APPLICATION FORMSECTION A: STUDENT DETAILSTitle (required) —Please choose an option—MrMissMrsMsOtherFirst Name (required) Last Name (required) Date of Birth (required) Nationality (required) Passport Number (required) Place of Issue (required) Do you hold an Australian Visa? YesNoVisa Expiry Date Email (required) Gender MaleFemaleOtherCountry of Birth (required) City of Birth (required) Country of Passport (required) Date of Expiry (required) Visa Subclass (If Yes) Visa Grant Number Phone (required) SECTION B: CONTACT DETAILSAddress in Overseas (required)Street Suburb/City State/Province Postcode CountryAddress in AustraliaStreet Suburb State PostcodeAny Disability or Impairment YesNo If Yes, please specify Emergency Contact Name (required) Emergency Contact Number (required) Relationship (required) Address (required) Email (required) SECTION C: EDUCATION HISTORYCourse NameInstitution NameCountryDate of CompletionSECTION D: EVIDENCE OF ENGLISHTest Type and Score IELTSPTEOthers Score Date of TestSECTION E: RPL/ CREDIT TRANSFERAre you seeking Recognition of Prior Learning or Credit Transfer? YesNoSECTION F: STUDENT SUPPORT INFORMATIONDo you need accommodation and/or airport pickup services? YesNoDo you have your Overseas Student Health Cover (OSHC)? YesNoWould you like Onepath College to arrange your OSHC? YesNoIf Yes, Cover Type SingleCoupleFamilyDo you have your USI (Unique Student Identification Number)? YesNo If Yes, please provide your USI Number For details information about the USI, please go to www.usi.gov.auSECTION G: COURSES AND INTAKESNational code and Course name CHC30125 Certificate III in Early Childhood Education and CareCHC50125 Diploma of Early Childhood Education and CareCHC33021 CERTIFICATE III IN INDIVIDUAL SUPPORTCHC52025 Diploma of Community ServicesSIT40521 CERTIFICATE IV IN KITCHEN MANAGEMENTSIT50422 DIPLOMA OF HOSPITALITYICT50220 DIPLOMA OF INFORMATION TECHNOLOGYICT60220 ADVANCED DIPLOMA OF INFORMATION TECHNOLOGYIntakes: 202605 Jan09 Feb06 Apr11 May06 Jul10 Aug05 Oct09 NovIntakes: 202704 Jan8 Feb05 Apr10 May05 Jul10 Aug06 Oct09 NovSECTION H: TUITION FEESNote: For courses more than 24 weeks you are not required to pay more than 50% of the Tuition Fee up front BUT YOU MAY DO SO VOLUNTARILYI wish to pay more than 50% tuition fee up frontSECTION I: MARKETINGAre you applying through an agent YesNoIf yes, name of the agent SECTION J: CHECKLISTCompleted all section of this form Enclosed copy academic transcript and completion certificate Enclosed a copy of your passport bio data page Enclosed copy of English Proficiency Test Provided other supporting documents (if applicable) SECTION K: PRIVACY NOTICEWhy we collect your personal information?As a registered training organisation (RTO), we collect your personal information so we can process and manage your enrolment in a vocational education and training (VET) course with us.How we use your personal information?We use your personal information to enable us to deliver VET courses to you.How we disclose your personal information?We are required by law to disclose the personal information we collect about you to the National VET Data Collection.SECTION L: STUDENT DECLARATION I declare that the information provided is true and correct I agree to the collection, use and disclosure of my personal information as per the Privacy NoticeName of applicant (required) Signature Date (required)
