www.academies.edu.au pdf enrolmentform aap melb

8/11/2019 Www.academies.edu.Au PDF EnrolmentForm AAP Melb

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Page 1 of 4 Version3- Academies Australasia Polytechnic Pty Limited

CRICOS CODE 02439G

INTERNATIONAL STUDENT APPLICATION FORMNB: All fields marked

*are mandatory. Details must be entered before an application can be processed

PERSONAL DETAILSFamily Name * _________________________________________________________________

Given Name * _________________________________________________________________

Victorian Student Number (VSN):________________________(if applicable)

Date of Birth * _____/_____/________ (DD/MM/YYYY)

Gender Male Female

FOR INTERNATIONAL STUDENTS ONLY:

Passport Number * _____________________________________

Nationality * _____________________________________

Country of Birth * _____________________________________

Are you currently in Australia? Yes No

What visa type do you have/will apply for? *

Student Visa Tourist

Permanent Resident Other ________________________________

Visa Expiry Date _____/_____/_______ (DD/MM/YYYY)

Visa Number ______________________________________

CONTACT DETAILSHome Phone Number * ___________________________________

Mobile Phone Number * ___________________________________

Email * ________________________________________________________

Address * ________________________________________________________

_______________________________ Post/Zip Code ____________

Overseas Student Health Cover (OSHC)Do you require OSHC?

Yes (please select from options below) No (please provide details)

Single Family ___________________________________

ENGLISH PROFICIENCY

IELTS Overall Score ________________________

Other ________________________

LEARNING LIMITATIONSVisual, Hearing, Speech impairment

Other disabilities ____________________________________________________

EDUCATIONAL QUALIFICATIONSHighest Education Qualification _____________________________________________________________

Institution ___________________________

Year Awarded ___________________________

Country ___________________________

Are you currently studying? Yes (If yes, please give details below) No

School / Institution ____________________________________________Commence: _____/_____/_____ Complete: _____/_____/_____

If you are currently studying in Australia, please attach Current Electronic Confirmation of Enrolment (eCoE)

Are you requesting a Credit Transfer? Yes No

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CRICOS CODE 02439G

ACCOMMODATION AND AIRPORT PICK UPI require Home Stay Yes No

I require Airport Pick Up Yes No

AGENT DETAILS

I authorize the agent detailed below to receive information related to my application.

Scholarship/Promotional Code ______________________________________________________________

How did you hear about Academies Australasia Polytechnic?

Agent

Website

AAP Window

Friend

Print advertising

Exhibition

Other

____________________________________________

APPLICATION CHECKLIST

Before submitting your application, please ensure all sections of application form are completed and attach the following:

Certified copies of your academic qualifications

Evidence of your English Language Proficiency

Copy of your passport

Copy of your eCoE

Copy of your valid visa (if applicable)

Copy of your valid OSHC (if applicable)

Credit Transfer Application Form (if applicable)

STUDENT DECLARATIONPRE-ENROLMENT CONDITIONS1 I have read and understand the course and fee information on the Academies Australasia Polytechnic website,

http://www.polytechnic.academies.edu.au and in the course information brochure.2 I understand that Australian law requires student visa holders to notify their Education Provider of any change of address details within 7 days.3 I understand that it is compulsory to be covered by Overseas Student Health Cover while I am on a student visa.4 I understand that I am not eligible to transfer to another registered provider, without permission from Academies Australasia Polytechnic Pty Ltd until I

have completed 6 months of my principal course of study.5 I understand that continuation in the course/s is dependant upon satisfactory academic progress and attendance. Failure to meet these conditions will

result in my case being reported by Academies Australasia Polytechnic Pty Limited to DIAC.

6 I acknowledge that information about the ESOS Framework can be found athttp://www.aei.gov.au/Regulatory-Information/Pages/Regulatoryinformation.aspx .It is important for international students to understand the ESOS Framework. The Education Services for Overseas Student Act (ESOS) andregulations set out the legal framework governing delivery of education to overseas students studying in Australia on a student visa.

7 I understand that information collected about me may be shared between the registered provider and the Australian Government and designatedauthorities and, if relevant, the Tuition Assurance Scheme and the ESOS Assurance Fund Manager. This information includes personal and contactdetails, course enrolment details and changes, and the circumstance of any suspected breach by the student of a student visa condition. In other

instances information collected on this form can be disclosed without your consent where authorised or required by law.8 I acknowledge that Academies Australasia Polytechnic is committed to protecting an individuals right to privacy in accordance with the Privacy Act

2001.9 I acknowledge that Academies Australasia Polytechnic reserves the right to alter any course, subject, admissions requirement or fee without notice.10 I understand that the Community Services program requires a Police Clearance and a Working with Children Check. I also understand that this

program includes an unpaid 400 hour work placement mainly with community services and organisations whose staff and clients include those fromdiverse language and cultural backgrounds. I understand that I will be dealing with both male and female clients, the elderly, youth, children, those withdisabilities, mental and physical, as well as individuals different sexual affiliations/preferences, the homeless, drug addicts amongst others.

11 I understand that students in the Hospitality Management programs will be required to handle and prepare meat and meat products in practicallessons. Students may wear gloves when handling meat. One meat cannot be substituted for another meat. Academies Australasia Polytechnic willuse halal meat when possible. Alcohol may also be used in some practical lessons.

12 I understand that for the English courses, I need to have a minimum attendance of 80 percent; otherwise, Academies Australasia Polytechnic mayreport me to DEEWR-DIAC for breaching the 80 per cent attendance requirement.

13 I have read, understood and agreed to Academies Australasia Polytechnic Refund Policy found at http://www.polytechnic.academies.edu.au/Admissions/Refund-Policy.

14 I am aware that Academies Australasia Polytechnic accepts students with a minimum age of 18 years.

I, _____________________________________________________________________________

Hereby declare that the information supplied in this application and the supporting documentation is true and

correct. I have read, understood and agreed to the terms and conditions.

Signature: __________________________ DD/ MM/ YYYY (Please complete the course selection onPage 3 &4)

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CRICOS CODE 02439G

ELICOS NUMBER OF WEEKS COMMENCEMENT DATE

General English (046514E) ___________________________ _____/_____/___________

IELTS (067634A) ___________________________ _____/_____/___________

Commencement Dates (General English & IELTS):

2012:Every Monday

2013:Every Monday, commencing 07/01/2013

EAP 1 (054830D) ___________________________ _____/_____/___________

Commencement Dates

2012: 2/1, 6/2, 12/3, 16/4, 21/5, 25/6, 30/7, 3/9, 8/10, 12/11

2013: 07/01, 11/02, 18/03, 22/04, 27/05, 01/07, 05/08, 09/09, 14/10, 18/11

EAP 2 (054831C) ___________________________ _____/_____/___________

Commencement Dates

2013: 07/01, 11/02, 18/03, 22/04, 27/05, 01/07, 05/08, 09/09, 14/10, 18/11

HIGHER EDUCATION

Commencement of Higher Education (please tick one) MAR JUL NOV

Are you applying fo r Course Credit? YES NO

(Please complete credit transfer application form)

COMMENCEMENT DATE

Bachelor of Tourism & Hospitality Management _____/_____/___________

VOCATIONAL COURSES

Commencement of Vocational Courses (please tick one) JAN APR JUL SEPT

Are you applying fo r Course Credit? YES NO

(Please complete credit transfer application form)

COMMENCEMENT DATE

Cert II in Business (074368M) _____/_____/___________

Cert III in Business (074370F) _____/_____/___________

Cert IV in Frontline Management (074371E) _____/_____/___________

Dip. of Management (074372D) _____/_____/___________


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CRICOS CODE 02439G

Adv. Dip. of Management (074367A) _____/_____/___________

Cert III in Accounts Administration (076991E) _____/_____/___________

Cert IV in Accounting (076992D) _____/_____/___________

Dip. of Accounting (076993C) _____/_____/___________

Adv. Dip. of Accounting (076994B) _____/_____/___________

Cert II in Information Technology (076996M) _____/_____/___________

Cert III in Information Technology (076997K) _____/_____/___________

Cert IV in Information Technology (076998J) _____/_____/___________

Dip. of Information Technology (076999G) _____/_____/___________

Adv. Dip. of Information Technology (077000G) _____/_____/___________

Student Name: ___________________________________

Student Signature: ___________________________________ _____/_____/___________

Student Services Officer Name: ______________________________

Student Services Officer Signature: ______________________________ _____/_____/___________

www.academies.edu.au pdf enrolmentform aap melb

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