口 Yes 口 No 口Yes 口No - TAFE NSW - Northern Sydney Institute

OFFICE USE ONLYApplication No.:Application for Admission into aTAFE NSW Higher Education CourseReceipt Date:TO COMPLETE THIS FORM:Section 1 requires you to provide general information about yourself.Section 2 requires you to provide information specific to the course you are applying for.You must complete both Section 1 and Section 2.You must answer all questions.Print out and sign your application and send it to the address indicated on page 4.Incomplete applications will not be processed.PLEASE NOTE: This application for admission DOES NOT constitute an offer of enrolment.SECTION 1 – PERSONAL DETAILSHave you previously been enrolled in TAFE? Yes NoFamily nameFirst given nameOther given name/sDate of birth / / Sex: Male FemalePostal Addressdate / month / yearSuburb / townPostcodeCountry of postal address(if not Australia)Email addressPhone Numbers (please indicate in the right hand column which number you prefer to be contacted on)HomeWorkMobileMay we contact you regarding your application via SMS messaging? Yes No13 March 2012 1

TAFE NSW Higher Education Application Form Section 1Name of Applicant:Do you give permission for TAFE NSW Higher Education to contact youwith further information about courses? Yes NoDo you give permission for TAFE NSW Higher Education to contact you formarket research purposes? Yes NoDo you speak a language other than English at homeIf yes, which language? Yes NoDo you require assistance with completing this form? Yes NoIf your answer is “yes”, you should contact a TAFE NSW Teacher Consultant for Students withDisabilities, who can provide you with help to complete this form. Contact details for TAFE NSWConsultant for Students with Disabilities are available at the campus enrolment centre or on theTAFE NSW website http://www.tafensw.edu.au under: Students – Support Services.Are you an Australian Aboriginal or Torres Strait Islander?If you are both an Australian Aboriginal and Torres Strait Islander, mark both boxes. No Yes, Aboriginal Yes, Torres Strait IslanderPlease indicate your citizenship / residency status: Australian citizen Australian permanent resident New Zealand citizen Australian temporary visa holderMy visa sub class is: _________________ Permanent humanitarian visa holderPlease go to Section 2 of the application form13 March 2012 2

TAFE NSW Higher Education Application Form Section 2Name of Applicant:Part E: Applicant ChecklistBefore submitting your application, you should check that you have: Attached copies of documents as evidence of your educational achievement. Do not attach originals.If any of your documents are in a language other than English, you must provide certified translations of thesedocuments. You can contact a TAFE NSW Counsellor or Multicultural Education co-ordinator if you need assistance toprovide this evidence. Attached or included any additional material you have been asked to provide (eg: transcripts of educationalachievement, essay). Labelled all additional material and with your name, contact numbers and the name of the course you are applying for. Made a copy of your application form and additional material to keep for your own reference.Applicant Declaration• This form has been completed by me personally and the information I have given is true and correct.• I understand that the evidence I have provided with this application will need to be verified at enrolment if I am made anoffer.• I consent to TAFE NSW Higher Education obtaining personal information necessary to complete or verify this application.• I understand that TAFE NSW Higher Education will not accept responsibility for incorrectly completed forms, forms sentto the wrong address, or the return of original documents or materials.• I understand that this application does not guarantee a place in the course.SignatureDateLODGING YOUR APPLICATIONYou can lodge your application in person at:Meadowbank CampusStudent Administration – Higher EducationLevel One , Building JSee St, Meadowbank NSWYou can scan and email your application to:NSI.ITdegree@tafensw.edu.auYou can mail your application to:Attention: Higher EducationMeadowbank CampusStudent Administration – Higher EducationTAFE NSW Northern Sydney InstituteSee St ,Meadowbank NSW 2114CLOSING DATE FOR RECEIPT OF APPLICATIONS1. Applications to be considered in the first round must be submitted by 4pm Friday 1 st June 2012. Applications maycontinue to be made prior to the commencement of classes, as long as places are still available.FOR FURTHER INFORMATION, PLEASE CONTACT:Course Co-ordinator, Bachelor of Information Technology (Network Security) on +61 (0)418 799 567Customer Contact Centre, 131674 ORSend your enquiry by email to: NSI.ITdegree@tafensw.edu.auORPrivacy:Information concerning applicants and students is collected and held by the TAFE NSW Commission (having its principal office located atLevel 2, 35 Bridge Street Sydney NSW 2000). The information on this application form will be used by TAFE NSW Higher Education and/orother authorised organisations for the purpose of general student administration, identification, communication, state and nationalreporting, program monitoring and evaluation. The provision of information in this application form is not required by law, but isnecessary to determine your eligibility for a place in the TAFE NSW course named on this application form.Information you provide will be held securely and disposed of securely when no longer needed. You may access, correct or amend yourpersonal details by contacting the college where you lodged you application form.13 March 2012 4