Application for Admission to QUT as an International Student (F form)

+ +Using this formQueensland University of TechnologyStudent Business ServicesVictoria Park RoadKelvin Grove Qld 4059 AustraliaPhone +61 7 3138 2000FFax +61 7 3138 3529www.international.qut.edu.auCRICOS No. 00213J ABN 83 791 724 622ID NoRepresentative’s stamp / date receivedApplication for Admission to QUT as an International Student11031. Please complete all sections and print neatly in BLOCK LETTERS, scan and submit to qut.intadmission@qut.edu.au2. Do not use this form if you are a citizen of Australia or New Zealand or a permanent resident of Australia or the holder of an Australian permanentvisa.3. You will need to pay a non-refundable application fee of AUD$55 (AUD$50 + 10% GST) when you submit this form (complete section 11 ‘Paymentof application fee’).4. There can be additional admission entry requirements such as a portfolio, audition or interview if you are applying for a course in the CreativeIndustries faculty.5. Please note: You must be at least 17 before commencement of your course.1. Personal detailsOffice use onlyTitle (Mr, Miss etc) Surname or family name Given namesMale Female Date of birth / / Current age Citizenshipday month yearPermanent address in home countryCurrent address(If you are a current QUT student, allcorrespondence will be sent to your student emailaddress.)TelephoneCell/mobileTelephoneCountry code Area code Number Country code Area code NumberCell/mobileCountry code Area code Number Country code Area code NumberEmailFaxCountry code Area code Number Country code Area code NumberFaxHave you applied to QUT before? Yes No If yes, please quote your QUT student ID number N2. Preferred course of studyProposed year of entry Proposed teaching period of entry Feb Jun/Jul Oct/Nov** Limited courses available. Please referto studyfinder.Course code Name of course Course major /specialisation /ED38 teaching area nomination(you must complete this section)1.2.3.3. QUT International College coursesCourse (Please specify Bachelor program and Major)QC02 Foundation / QC04 Extended Foundation + Bachelor of MajorIT10 / BS40 / IF06 University Diploma + Bachelor of Major4. Current passport and visa statusDo you have a current passport Yes g Include copy of passport. No / /Date passport available (dd/mm/yyyy)Are you currently in Australia? Yesg What type ofvisa do you have?(You must include a copy ofyour current Australian visawith your application)Student Which institution are you studying at ?Other visaWhat visa type?+No I will apply for a student visa.+Page

+ +5. Educational qualificationsPlease give details of all your secondary education and other post-secondary courses that you have attended or are currently studying. You mustattach certified copies of your academic results, including English translations where necessary. QUT GMAT code is 1677.Original academic records or portfolios will not be returned..Name of school or institutionName of qualification or examination(eg SPM, STPM, GCE ‘O’ and ‘A’ level, BSc, etc)Attendance datesmonth/year to month/yearCoursecompleted?yes/noDo you intend to apply for exemptions (credit) on the basis of previous tertiary study? Yes NoHave you ever been excluded from previous tertiary study? If yes, please attach details.If you have previously completed a degree course at QUT do you wish to be consideredfor the QUT alumni scholarship for a subsequent QUT degree course?This scholarship offers a 20 per cent reduction in the first semester’s tuition fees. To be eligible applicants must not use an agent at any stage duringthe application process, full details are at www.international.qut.edu.au/apply/scholarships6. English proficiencyPlease tickappropriateboxesI have taken an: IELTS (academic) test TRF Test Report Form numberTOEFL test (QUT TOEFL code is 9778).YesYesNoRegistration numberI will take a test on: / /day month yearYou MAY be exempt from taking a formal test if your secondary or tertiary studies were conducted entirely in English and you have passed anEnglish language or one or more Communication subjects. Please refer to English Language http://www.international.qut.edu.au/apply/entryrequirements/english.jspfor further information about the minimum level of English proficiency requirements for admission to QUT courses.7. Employment detailsSome postgraduate courses, eg Master of Business Administration, require work experience for course admission. For QUT admission entryrequirements refer to Studyfinder at www.studyfinder.qut.edu.au Provide certified/originals of dated work experience statements fromemployers or other appropriate evidence.Years....... to .......Full-time/part-time Description of occupation and experience EmployerApplicants for ED26 and NS40 only: I certify that I have the necessary qualifications to be professionallyregistered in my home country as a teacher/nurse. If yes, provide certified evidence of registration.8. Supporting statement / extra informationYou may wish to provide extra information to support your application. Also, if you have any disability that may affect your learning (eg vision, health, mobility)you should provide early advice so the University may assist you. Please attach additional information on a separate sheet.9. Privacy statementThe information collected on admission forms is used to determine whether you may be offered admission to the University. If you enrol as a student of QUT,the information you have provided on this admission form will be used to administer your enrolment, to offer other services to you and to provide statisticalinformation to the Commonwealth Government as required by law. For full details of QUT’s practices regarding student information and privacy www.studentservices.qut.edu.au/info/contacts/QUT_u/privacy.jsp10. Declaration (all applicants must sign)By submitting this application I agree to comply with the statutes and rules of Queensland University of Technology that apply to me and as documented on the QUTwebsite available at www.mopp.qut.edu.au/Appendix/. I further agree that I am subject to and must comply with any policies or procedures of the University governing myconduct as a student, and academic matters affecting my studies, including but not limited to, the QUT Student Code of Conduct www.mopp.qut.edu.au/E/E_02_01.jspand the procedures for management of student discipline www.mopp.qut.edu.au/E/E_08_01.jsp. I declare that to the best of my knowledge the information supplied byme is true, correct and complete in every respect. I acknowledge that the submission of false, incorrect, incomplete or misleading information may result in cancellation ofmy enrolment or delays in processing. I acknowledge that I am responsible for the payment of all student fees and charges applying to my admission and study at QUT.QUT shall not be liable for any failure to provide services (including lectures, tutorials or examination results) or any teaching or other materials to students where suchfailure is due to circumstances beyond QUT’s control. Such circumstances include, but are not limited to, natural disasters, malicious damage, outbreak of pandemicdisease, industrial action or strikes, acts of war or acts of God. I acknowledge that it is my responsibility to provide all necessary documentary evidence of qualificationsor experience. I authorise QUT to verify such records through QualSearch or grant my consent for other educational institutions, admissions centres, government bodiesor employers to disclose information about my qualifications and experience directly to QUT.I have read and understood the University’s admission procedures at www.international.qut.edu.au/apply/, admission requirements at www.international.qut.edu.au/apply/entry-requirements/, privacy statement, and the international tuition fee and refund policy and its conditions at www.studentservices.qut.edu.au/costs/schedule/table_j/int_refund/. I am aware of the likely costs of my stay in Australia and I understand that neither QUT nor the Australian Government is obliged to help me if I requirefinancial assistance. I understand that if I have children between the ages of 6 to 15 who will accompany me in Australia, I will be required to pay compulsory school fees.I understand that any information I provide to QUT may be made available to Commonwealth and State Government agencies, and to the Fund Manager of the ESOSAssurance Fund, pursuant to obligations under the ESOS Act 2000 and the National Code.Applicant signature Date / /day month yearParent / Guardian signature(if applicant under 18)If you are using the services of a formal QUT representative to process your application, all communication about your application will occur with that representative.11. Payment of application feeApplication fee TOTAL: AUD$55.00 g To pay application fee visit http://qutpay.qut.edu.au and select ‘New International Student Payments’.Please quote your QUTPay transaction number(Transaction number can be found on transaction receipt)Do NOT send cash or personal cheques to QUT.+ +YesNoPage