undergraduate - UNSW International - The University of New South ...

International UndergraduateaPPlication Form page 26. English Language Proficiencya. english is my first language: Yes Nob. I have undertaken studies in which the language of instruction was English:NoYes – please provide details and supply documentation:c. I have a valid* English Language Test (TOefl, IelTS, UeeC, CPE) result.YesNo (*expires 2 years after test date)Test Name:Test Date (dd/mm/yy):Test Score:d. I will beSitting for a testReceiving results from a testTest Centre will send results to UNSW Yes NoTest Name:Test Date (dd/mm/yy):*You MUST include original English Language Test results7. FundingHave you been awarded a scholarship or sponsorship?YesNoIf yes, provide name and evidence of scholarship/sponsor:9. Privacy StatementThe information you provide on this application form is ‘personal information’as defined by the Privacy and Personal Information Act, 1998 (NSW) [theAct]. It is collected and held by UNSW in order to assess and follow up yourapplication for admission and for administrative and statistical purposes,or to send you information about UNSW activities relevant to your admissionand or enrolment. We may give your information to others inside and outsideNSW to facilitate this.You have the right of access to, and alteration of, theinformation concerning yourself in accordance with the Act and the UNSWPrivacy Management Plan. UNSW will not disclose your personal informationwithout your consent and without due cause, except as authorised by law-set out in this Statement. You have the right to refuse this consent, but ifthe consent is not given your application may not be processed. By signingthis document you accept these conditions.10. DeclarationI declare that the information submitted in this application is correct andcomplete. I authorise the University to obtain and verify information fromany educational institution previously or currently attended by me, includingthrough the use of Qualsearch. If any information supplied by me is consideredto be untrue, incomplete or misleading in any respect, I understand theUniversity may take such action as it believes necessary including thedisclosure of the information to any person or body the University considershas a legitimate interest in receiving it and I consent to such disclosure. Iunderstand the University reserves the right to vary or reverse any decisionmade on the basis of untrue, incomplete or misleading information.SignatureDate (dd/mm/yy):8. Check LiST(Your application cannot be considered unlessAll essential documents are attached.)I have included with this application form:The application fee (non-refundable) of A$100 payable by bank draft/bank cheque in Australian dollars made out to The University of New SouthWales or complete the credit card authorisation for payment sectionbelow. Payable per application.Original or certified copies of secondary and previous tertiary studies(awards gained, marks and grades).If not in English, official translations in English plus copies of the originallanguage document will be required. Self-translated documents are notaccepted and are considered fraudulent.English Language proficiency test result (must be an original copy).IelTS required for package offer.Video, audio tape or portfolio if required.Copies of documents can be certified by:Public Notary, staff of Australian diplomatic missions, Justice of the Peacewith registration number, administration of institution which issued thedocument, official representatives of UNSW, UNSW offshore office staff.(NOTE: Unsigned Applications will NOT be processed)If you are under 18 years of age your parent/legal guardian must sign thisform.Send your completed Application and Application Fee to:Postal address:Direct Admissions OfficeUNSW Sydney NSW 2052 AustraliaFax +61 2 9662 1049Street Address:Direct Admissions OfficeThe University of New South WalesLower Ground Floor, Chancellery BuildingGate 8 or 9, High Street, Kensington, NSW, 2052 AustraliaApplication Deadlines for All FacultiesSemester 1 > 31 October 2010Semester 2 > 30 April 2011ORwhen intake quotas have been reached, whichever is the earlier. Lateapplications may be considered where quotas have not been reached.However, the University does not guarantee applications can be processed intime for the requested start date. MBBS applicants should apply as early aspossible.Application Fee PaymentI wish to pay the UNSW Application Fee of A$100 by credit card:Mastercard VisaCARD No.Expiry Date / (month/year)Cardholder’s NameSignatureDate (dd/mm/yy):