1. perSonAl DetAilS - Central Queensland University
1. perSonAl DetAilS - Central Queensland University
1. perSonAl DetAilS - Central Queensland University
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Application for enrolment<br />
Cross-Institutional/Dual Enrolment<br />
Australian International Campus and<br />
Full Fee Paying International students only<br />
<strong>1.</strong> PERSONAL DETAILS<br />
Title Mr Mrs Ms Miss Other<br />
Mr Mrs Ms Miss Dr<br />
Family name<br />
Family Given names<br />
Previous family name<br />
First or other names<br />
Date of birth (DD/MM/YY)<br />
Gender<br />
(see note 1)<br />
Male<br />
Female<br />
Date Have of you birth been (DD/MM/YY) enrolled at CQ<strong>University</strong> previously Yes No Student number (if Gender known)<br />
Male Female<br />
What Overseas is your home address address in your home country<br />
Town/city Home address<br />
Country<br />
Town/city Contact address<br />
Country<br />
Town/city<br />
Postcode<br />
Postcode/ZIP<br />
Postcode<br />
Telephone Country number<br />
Mobile<br />
Telephone number<br />
Facsimile number<br />
Mobile<br />
Facsimile number<br />
Email address<br />
Email address<br />
Have you been enrolled at CQ<strong>University</strong> previously Yes No Student number (if known)<br />
@<br />
Are you the first in your family to attend tertiary education Yes No<br />
What are your current contact details<br />
Home address<br />
Print your country of citizenship as shown in your passport<br />
Town/city<br />
Passport number<br />
Postcode/ZIP<br />
Country<br />
Do you hold a current Australian visa<br />
Telephone number<br />
If yes, what is the visa category<br />
Yes<br />
No<br />
Mobile<br />
Expiry date<br />
Facsimile number<br />
Email address<br />
@<br />
Agent Details. Place stamp below (if applicable)<br />
Is an agent representing you<br />
Yes<br />
No<br />
What country are you in when completing this form<br />
Counsellors name<br />
Email address<br />
Where should we send notification of your application results Home country Contact<br />
Agent
2. CITIZENSHIP<br />
Print your country of citizenship as shown in your passport<br />
Passport number<br />
Do you hold a current Australian visa<br />
Yes<br />
No<br />
If yes, what is the visa category<br />
Visa code<br />
Visa type<br />
What is your country of birth<br />
3. Enrolment Details<br />
In what program (course) are you currently enrolled at your home university<br />
eg Bachelor of, Master of<br />
Intended mode of study (tick one box).<br />
Internal<br />
External<br />
Intended study load at CQ<strong>University</strong> (tick one box)<br />
Full-time<br />
Part-time<br />
Campus (tick one box)<br />
Brisbane<br />
Sydney<br />
Rockhampton<br />
Gold Coast<br />
Melbourne<br />
Note: Not all courses are available at all campuses or in all modes. Please refer to the on-line student handbook at http://handbook.cqu.edu.au.<br />
External students are automatically assigned a campus of FLEXIBLE (FLEX).<br />
Intended commencement term (tick one box). Refer to closing dates for each term and course availability in the handbook before selecting.<br />
Term 1 Term 2 Term 3<br />
Examination centre.<br />
Please refer to the enclosed list of<br />
examination centres<br />
4. Documents Required<br />
You must attach a signed LETTER OF APPROVAL from your home institution stating that you will be granted credit, on completion, for all courses in which<br />
you apply to enrol at CQ<strong>University</strong>. You should provide either the original of this letter or a certified photocopy. Certification may be obtained from a<br />
Justice of the Peace or a Commissioner for Declarations. APPLICATIONS SUBMITTED WITHOUT A LETTER OF APPROVAL WILL NOT BE PROCESSED.<br />
5. Course Enrolment<br />
Please enter the course code, mode, course name and term for all courses you wish to undertake (see note 2).<br />
Course code Mode (Int/Ext) Course name Term1/Term 2/Term 3<br />
6. I learnt about cquniversity through<br />
Personal contact/email (please specify)<br />
Education Institution (eg GAC, Polytechnic, <strong>University</strong> Etc)<br />
Website (please specify)<br />
Advertisment (eg magazine, newspaper, etc)<br />
Australian Education Centre/Australian Education International<br />
Private Agent<br />
Educational exhibition/seminar<br />
Australian Diplomatic Mission<br />
Other (please specify)
7. DECLARATION<br />
You must sign this declaration otherwise your application will be returned to you<br />
I declare the information supplied by me on this form is true and correct in every particular. I authorise CQ<strong>University</strong> to obtain from other educational<br />
institutions and relevant authorities details of my enrolment, academic record, examination results and bond status.<br />
Applicant’s signature<br />
Date<br />
(DD/MM/YY)<br />
8. NOTES<br />
<strong>1.</strong> Previous family name<br />
Applicants who have previously been enrolled at CQ<strong>University</strong> or its antecedents (UCQ, UCCQ or CIAE) under a different name to the one in which<br />
they are now applying, or applicants whose supporting documents are not in the applicant’s current name (as it appears on this application form)<br />
must include a certified copy of the relevant documentation validating the name change (eg marriage certificate, deed poll or decree nisi).<br />
2. Course enrolment<br />
In CQ<strong>University</strong> terminology, a ‘course’ is a subject or unit of study. You will only be enrolled in courses for which you have provided written<br />
approval from your home university. Please check the availability and the mode of the courses you select in the on-line student Handbook on the<br />
web at http://handbook.cqu.edu.au/crseavail/index.html. Should you wish to change your course selection at any time, you must provide further<br />
written approval to the International Admissions Officer.<br />
9. CHECKLIST<br />
Completed ALL sections of the Application Form<br />
Attached certified proof of name change (if applicable)<br />
Attached original certified copy or original copy of your approval letter<br />
Signed the Declaration<br />
10. SUBMIT YOUR APPLICATION<br />
Please submit this application to the CQ<strong>University</strong> campus you wish to study in.<br />
Campus Location Application sent by Email Application sent by Post<br />
Rockhampton<br />
Brisbane<br />
Gold Coast<br />
Melbourne<br />
Sydney<br />
Distance Education<br />
int-enquiries@cqu.edu.au<br />
enquiries@bris.cqu.edu.au<br />
enquiries@goldcoast.cqu.edu.au<br />
enquiries@mel.cqu.edu.au<br />
enquiries@syd.cqu.edu.au<br />
int-enquiries@cqu.edu.au<br />
Admissions Centre<br />
PO Box 10437<br />
Southport QLD 4215<br />
CRICOS Provider Codes: QLD 00219C; NSW 01315F; VIC 01624D<br />
JN10-1122
Examination centres/study locations<br />
The centre you select from this list indicates where the <strong>University</strong> will organise for you to sit any formal examinations during the course of your study.<br />
Students should refer to the Student Handbook at www.cqu.edu.au regarding the rules relating to examinations and the selection of an examination centre.<br />
All internal students must sit at their campus of enrolment (Students enrolled at Noosa Hub, see note below). External students should choose a convenient<br />
location within 100kms of your residence, please contact the Examinations Section if there is none listed. All students may view their personal examination<br />
timetable via the Student Centre in CQUcentral.<br />
If any student is unable to view their examination schedule in CQUcentral, two weeks prior to the examination period, the Examinations Section should be<br />
contacted on (07) 4930 9440 or (07) 4930 9377 or by fax on (07) 4930 6702 or by email to examinations@cqu.edu.au.<br />
<strong>Queensland</strong><br />
Airlie Beach<br />
Alpha<br />
Atherton<br />
Bamaga<br />
Baralaba<br />
Barcaldine<br />
Beaudesert<br />
Biggenden<br />
Biloela<br />
Blackall<br />
Blackwater<br />
Boulia<br />
Bowen<br />
Brisbane Campus<br />
Bundaberg Campus<br />
Burketown<br />
Cairns<br />
Cannington Mine<br />
Charleville<br />
Charters Towers<br />
Chinchilla<br />
Clermont<br />
Cloncurry<br />
Collinsville<br />
Cooktown<br />
Cunnamulla<br />
Darnley Island<br />
Dirranbandi<br />
Duaringa<br />
Dysart<br />
Edmonton<br />
Emerald<br />
Forsayth<br />
Fraser Island<br />
Gatton<br />
Gayndah<br />
Gladstone Campus<br />
Glenden<br />
Gold Coast Campus<br />
Goondiwindi<br />
Greenvale<br />
Gympie<br />
Hamilton Island<br />
Hervey Bay<br />
Home Hill<br />
Horn Island<br />
Hughenden<br />
Imbil<br />
Ingham<br />
Innisfail<br />
Ipswich<br />
Jandowae<br />
Julia Creek<br />
Kingaroy<br />
Kowanyama<br />
Logan<br />
Longreach<br />
Mackay Campus<br />
Mareeba<br />
Maryborough<br />
Middlemount<br />
Miles<br />
Miriam Vale<br />
Mitchell<br />
Monto<br />
Moranbah<br />
Mossman<br />
Moura<br />
Mt Isa<br />
Mundubbera<br />
Normanton<br />
Phosphate Hill Mine Site<br />
Quilpie<br />
Ravenshoe<br />
Redcliffe<br />
Richmond<br />
Rockhampton Campus<br />
Roma<br />
Russell Island<br />
Springsure<br />
St George<br />
St Lawrence<br />
Stanthorpe<br />
<strong>Queensland</strong> cont/d<br />
Stradbroke Island<br />
Sunshine Coast<br />
Tambo<br />
Tara<br />
Taroom<br />
Theodore<br />
Thursday Island<br />
Toogoolawah<br />
Toowoomba<br />
Townsville<br />
Tully<br />
Warwick<br />
Waterford<br />
Weipa<br />
Winton<br />
New South Wales<br />
Albury<br />
Armidale<br />
Bega<br />
Bourke<br />
Broken Hill<br />
Burren Junction<br />
Cobar<br />
Coffs Harbour<br />
Collarenebri<br />
Cooma<br />
Deniliquin<br />
Dubbo<br />
Goulburn<br />
Grafton<br />
Inverell<br />
Jindabyne<br />
Kempsey<br />
Kogarah<br />
Lismore<br />
Macksville<br />
Moree<br />
Moruya<br />
Murwillumbah<br />
Muswellbrook<br />
Newcastle<br />
Nowra<br />
Oberon<br />
Orange<br />
Parramatta<br />
Port Macquarie<br />
Queanbeyan<br />
Sydney Campus<br />
Tamworth<br />
Taree<br />
Tumut<br />
Wagga Wagga<br />
Wentworth Falls<br />
Wollongong<br />
Victoria<br />
Ballarat<br />
Benalla<br />
Bendigo<br />
Chadstone<br />
Churchill<br />
Geelong<br />
Hamilton<br />
Horsham<br />
Kalimna<br />
Leongatha<br />
Melbourne Campus<br />
Mildura<br />
Point Lonsdale<br />
Sale<br />
Shepparton<br />
St Arnaud<br />
Warrnambool<br />
Northern Territory<br />
Alice Springs<br />
Darwin<br />
Jabiru<br />
Katherine<br />
Nhulunbuy<br />
Rumingining<br />
Tennant Creek<br />
Yulara<br />
Australian Capital Territory<br />
Banks<br />
Canberra<br />
Griffith<br />
South Australia<br />
Adelaide<br />
Berri<br />
Elizabeth<br />
Flagstaff Hill<br />
Gawler<br />
Leigh Creek<br />
Mt Gambier<br />
Murray Bridge<br />
Port Augusta<br />
Port Pirie<br />
Roxby Downs<br />
Whyalla Norrie<br />
Western Australia<br />
Albany<br />
Bridgetown<br />
Broome<br />
Carnarvon<br />
Joondalup<br />
Esperance<br />
Exmouth<br />
Fremantle<br />
Geraldton<br />
Kalgoorlie<br />
Kambalda West<br />
Karratha<br />
Kununurra<br />
Manjimup<br />
Margaret River<br />
Merredin<br />
Moora<br />
Narrogin<br />
Newman<br />
Paraburdoo<br />
Perth<br />
South Hedland<br />
Southern Cross<br />
Tom Price<br />
Tasmania<br />
Burnie<br />
Hobart<br />
Launceston<br />
Rosebery<br />
St Helens<br />
Overseas<br />
Angola - Luanda<br />
Bahrain<br />
Bangladesh - Dhaka<br />
Bolivia - La Paz<br />
Brazil - Sao Paulo - BC<br />
Brunei - Darussalam<br />
Cambodia - Phnom Penh<br />
Canada - Calgary<br />
Canada - Edmonton<br />
Canada - Lake Louise<br />
Canada - Ottawa<br />
Canada - Owen Sound<br />
Canada - Thunder Bay<br />
Canada - Toronto<br />
Canada - Vancouver<br />
China - Beijing<br />
China - Guangzhou<br />
China - Shanghai<br />
China - Suzhou<br />
China - Zhongshan<br />
Colombia - Bogota<br />
Cook Islands - Rarotonga<br />
Cyprus - Nicosia<br />
Czech Republic - Prague<br />
Fiji – Suva<br />
France - Boulogne Sur Mer<br />
France - Paris<br />
Germany - Fulda<br />
Germany - Rostock<br />
Ghana (West Africa) – Accra<br />
Greece - Athens<br />
Overseas cont/d<br />
Guinea - Tingilinta<br />
Hungary - Budapest<br />
India - Ahmedabad<br />
India - Bangalore<br />
India - Chandigarh<br />
India - Chennai<br />
India - Hyderabad<br />
India - Kolkata (Calcutta)<br />
India - New Delhi<br />
Indonesia - Denpasar - Bali<br />
Indonesia - Jakarta<br />
Indonesia - Medan<br />
Indonesia - Surabaya<br />
Ireland - Cork<br />
Ireland - Dublin<br />
Italy - Perugia<br />
Italy - Torino<br />
Japan - Ageo City<br />
Japan - Komatsu City<br />
Japan - Nagoya<br />
Japan - Sendai City<br />
Japan - Tokyo<br />
Japan - Tsu<br />
Jordan - Amman<br />
Kazakhstan - Almaty<br />
Kazakhstan - Almaty<br />
Kenya - Mombasa<br />
Kuwait - Safat<br />
Laos - Vientiane<br />
Lebanon - Baabda<br />
Lebanon - Tripoli<br />
Macau<br />
Macedonia<br />
Malaysia - Kuala Lumpur<br />
Malaysia - Penang<br />
Malaysia - Sabah<br />
Malaysia - Sarawak<br />
Malaysia - Sibu<br />
Malta - Ta’xbiex<br />
Mexico - Morales<br />
Myanmar - Rangoon<br />
Nepal - Kathmandu<br />
Netherlands - Amsterdam<br />
New Caledonia - Noumea<br />
New Zealand - Auckland<br />
New Zealand - Christchurch<br />
New Zealand - Dunedin<br />
New Zealand - Gisborne<br />
New Zealand - Invercargill<br />
New Zealand - Nelson<br />
New Zealand - Ohakune<br />
New Zealand - Palmerston North<br />
New Zealand - Rotorua<br />
New Zealand - Timaru<br />
New Zealand - Whangarei<br />
Nigeria - Port Harcourt<br />
Oman - Ibri<br />
Oman - Izki<br />
Oman - Muscat<br />
Pakistan - Islamabad<br />
Pakistan - Karachi<br />
Pakistan - Lahore<br />
Pakistan - Peshawar<br />
Pakistan - Quetta<br />
Philippines - Makati<br />
PNG - Goroka<br />
PNG - Kimbe<br />
PNG - Kutubu<br />
PNG - Lae<br />
PNG - Lihir Island<br />
PNG - Port Moresby<br />
PNG - Tabubil<br />
Poland - Opole<br />
Qatar - Doha<br />
Romania - Bucharest<br />
Saudi Arabia - Dhahran<br />
Saudi Arabia - Jeddah<br />
Saudi Arabia - Khamis Mushayt<br />
Saudi Arabia - Riyadh<br />
Singapore<br />
Slovakia - Banska Bystrica<br />
Solomon Islands - Honiara<br />
South Africa - Durban<br />
Overseas cont/d<br />
South Africa - Johannesburg<br />
South Africa - Kimberley<br />
South America - Chile<br />
South Korea - Daejeon<br />
South Korea - Jeon Nam<br />
South Korea - Kyung Nam<br />
South Korea - Seoul<br />
South Korea-Suwon<br />
Spain - Madrid<br />
Sri Lanka - Colombo<br />
Sweden - Goteborg<br />
Sweden - Stockholm<br />
Switzerland - Geneva<br />
Taiwan - Kaohsiung<br />
Taiwan - Taipei<br />
Taiwan - Taipei<br />
Tanzania - Dar es Salaam<br />
Thailand - Bangkok<br />
Timor-Leste - Dili<br />
Tonga<br />
Turkey - Ankara<br />
Turkey - Istanbul<br />
UAE - Abu Dhabi<br />
UAE - Dubai<br />
UK - Bournemouth<br />
UK - Leeds<br />
UK - London<br />
UK - Oldham<br />
UK - Plymouth<br />
USA - Bellevue, WA<br />
USA - Bradenton, FL<br />
USA - Brooklyn NY<br />
USA - Burlington<br />
USA - Charlottesville, VA<br />
USA - Chicago, Il<br />
USA - Danbury, CT<br />
USA - Florida<br />
USA - Gresham, OR<br />
USA - Honolulu<br />
USA - Indianopolis<br />
USA - Kansas City, MO<br />
USA - Maryland<br />
USA - New Mexico - Melrose<br />
USA - Placerville, CA<br />
USA - Quantico, VA<br />
USA - Sacramento<br />
USA - San Diego, CA<br />
USA - Saranac Lake, NY<br />
USA - Stanford, CA<br />
Vanuatu - Port Vila<br />
Venezuela<br />
Vietnam - Hanoi<br />
Vietnam - Ho Chi Minh City<br />
Students seeking examination<br />
centres at Australian Military<br />
Facilities or Australian Correctional<br />
Centres are to contact the<br />
Examinations Section.<br />
Noosa Hub students should<br />
select the Sunshine Coast as<br />
their Study Location.<br />
Flexible study is not<br />
available to students in<br />
Hong Kong.<br />
Prepared by Examinations Coordinator – current as at 1 December 2008.
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