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

UNSW Institute of LanguagesApplication Form6. Future Study PlansDo you intend to do academic studies in Australiaafter this course? Yes No If yes, where? UNSW Foundation Studies UNSW Other universityLevel of course: Bachelor Degree (Undergraduate) Master Degree (Postgraduate) PhD (Doctorate)Name of courseFacultyDo you have a Letter of Offer? Yes No If yes, is it for: full offer package offer conditional offerCommencement date:Student ID Number (if available)7. Accommodation 2010/2011 For single students onlyDo you require us to arrange accommodation?Yes No If yes, please complete the following:Do you smoke? Yes No Are you happy to live with a host family with children? Yes No Are you happy to live with a family with pets? Yes No Are there any foods you cannot eat? Yes No Please specifyDo you have any allergies/health problems? Yes No Please specifyOther special requests? Yes No If yes, what are they?Accommodation feesA$245*accommodation booking feeA$1,020 part-board (4 weeks)A$760 room only (4 weeks)A$410*** under 18 years old fee*includes GST**under 18 years old: care arrangement fees apply***students under 18 have different accommodation pricesfees subject to changeAccommodation date:from / / to / /Do you require airport pick-up? Yes No If yes, please complete the following:Airport pick-up: A$150 Yes No Please provide arrival details at least two weeks(14 days) prior to scheduled departure.Arrival date:Airline/Flight number:Arrival time:8. Overseas Student Health CoverOverseas student health cover is compulsory for students onstudent visas.Do you require health cover? Yes No Single 3 months 3 to 6 months 6 to 9 months 9 to 12 months9. Agent InformationAgency NameContact nameEmail addressFamily 3 months 3 to 6 months 6 to 9 months 9 to 12 months10. Additional InformationHow did you hear about UNSW Institute of Languages?Name of any relatives or friends who have completed acourse here:YearDeclarationI certify that the information on the form is correct and completein every detail, and I understand that inaccuracies or omissionsmay result in non-acceptance or cancellation of enrolment at anytime. I agree to the Conditions of Enrolment which are at: (www.languages.unsw.edu.au/documents/Conditions_of_Enrolment_International.pdf) and the academic rules and policies aspublished on the website www.languages.unsw.edu.au fromtime to time and acknowledge that the personal informationprovided is covered under the Privacy Policy (required by law).Signature of StudentDateIf applicant is under 18 years of age the signature of aParent or Guardian is required.Signature of Parent/Guardian:(If student is under 18 years of age)Unsigned applications cannot be processed.Education Representatives cannot sign on behalf of the student.CorrespondenceLodge the completed form with a UNSW Institute ofLanguages agent or representative in your countryor post to:UNSW Global Student ServicesP.O. Box 853, Kensington NSW 1465, AustraliaTelephone: 61 2 9385 5396 Facsimile: 61 2 9662 2651Email: admissions@unswglobal.unsw.edu.auABN 62 086 418 582CRICOS Provider No. 01020K