Flinders University Assessment Centre Part A

Flinders University Assessment Centre

Section A: Student details (to be completed by applicant) (5 pages in total). The final page will need to be completed by the student and their parent/caregiver. It is possible to save progress and return to the form to complete later. This form is best viewed on Chrome, Firefox or Safari.
If you haven't already received the list of eligible courses, please click here to download them prior to commencing the application. Once downloaded you'll need to return to this page to complete your application.
1. Personal details
Student Name*

First NameLast Name
Date of Birth*

DayMonthYear
Gender*
Address*

Street Address

Street Address Line 2

SuburbState / Territory

Postcode
Email*
Mobile*

4. Proposed university study

For a full list of eligible courses through this pathway please refer to the accompanying list. For additional information regarding courses please visit: www.flinders.edu.au/study/courses
What course(s) are you interested in studying at Flinders, and why? (If you have undertaken any particular studies, or plan to, or have any experiences outside of education that you think relevant, please feel free to include this information)*

5. Applicant declaration
I certify that to the best of my knowledge all documentation and information submitted or made available by me to the University, whether in relation to any course of study or otherwise, are true, accurate and complete.

I acknowledge that the provision of inaccurate or incomplete information by me, may result in the withdrawal of any offer of enrolment, or the cancellation of any enrolment allowed on the basis of acceptance of that offer.

I consent to the collection, storage and disclosure of information relating to record falsification or other irregular acts in accordance with Universities Australia procedures.

I authorise Flinders University to disclose the personal information I have given in this application to the Department of Education and that the Department of Education will collect and store my personal information in the Higher Education Information Management System.

I accept that my participation and resulting performance within the Flinders University Assessment Centre will be used by the University to determine my eligibility for university study.

Iconsent (tick box)*
Parent/Caregiver/Legal guardian to complete
I(Insert NAME of parent/caregiver/legal guardian)* hereby give my consent to the above.

Iconsent(tick box)
Should be Empty:

	Yes	No
Are you an Aboriginal or Torres Strait Islander?
Are you an Australian citizen?
Are you a New Zealand citizen?
Are you a Permanent Resident visa holder?
Are you a Humanitarian visa holder?

Flinders University Assessment Centre