ACCHS_Enrolment Form

Student ID Number

Date

Gender*

MaleFemaleOther

Title*

Mr.Mrs.Ms.Other

Name*

Given Name/sFamily Name

Preferred Name

Date of birth*

Date

First Language*

Age

Disability*

YesNo

If yes, please provide details

Do you have Unique Student Identifier (USI) Number?*

YesNo

Create your USI here, or provide details if you are unable to create a USI.

Enter USI Number

I have not applied for a USI Number. Provide a reason:

Home country address*

Street Address

Street Address Line 2

City

Postal CodeCountry

Phone*

Mobile*

Email*

example@example.com

Australia address

Street Address

Street Address Line 2

City / Suburb

Postal Code

Phone

Mobile

Email*

example@example.com

Next of Kin*

Full name*

Phone*

Email*

example@example.com

Do you have an existing OSHC?*

YesNo

Expiry Date

DayMonthYear

Passport number*

Expiry Date*

DayMonthYear

What is your Nationality on your passport?*

Do you hold an Australian Visa*

YesNo

Country of issue

Visa type

Expiry Date

DayMonthYear

Name of Institution*

Completed Year*

Country/State*

Language of instruction*

IELTS Score: Type a label   Date
TOEFL Score: Type a label   Date
Other:   Type a label    Date

Attach details of other English language assessment including provider, date and copy of qualification

Are you currently enrolled in an ELICOS/English language school?*

YesNo

If Yes provide details

Select Course(s)*

CHC33021 Certificate III in Individual SupportCHC43015 Certificate IV in Ageing SupportCHC52021 Diploma of Community ServicesBSB50420 Diploma of Leadership and ManagementBSB50120 Diploma of BusinessBSB60120 Advanced Diploma of BusinessCHC30121 Certificate III in Early Childhood Education and CareCHC50121 Diploma of Early Childhood Education and Care

Date/s you wish to commence studies with ACCHS:*

Date

Which campus would you prefer to study at?*

Sydney CBD - Level 3, 432/450 Kent Street, Sydney NSW 2000Parramatta - Level 1 Suite 107, 30 Cowper Street, Parramatta NSW 2150

How did you first learn about ACCHS?*

Are you engaging with any agency?*

YesNo

If 'YES' please provide Agent name

Have you completed a course or are you currently studying in Australia?*

YesNo

Are you currently enrolled with another CRICOS Provider?

YesNo

If yes, do you have a Letter of Release?

YesNo

Do you require a Letter ofOffer to be released from your current provider?

YesNo

Why are you leaving your current course/provider?

Do you owe fees to your previous provider?

YesNo

If yes, provide details.

Did you abide by the conditions of your student visa with your previous provider (attend class and progress in your course)?

YesNo

If no, provide details.

Have you had your previous course cancelled?

YesNo

If yes, provide details.

When did you complete your course with your previous provider in Australia?

Evidence e.g. certified copy of Certificate of Completion is required

I understand that by signing this application form, I may be sent a Formal Letter(s) of Offer/Written Agreement Contract from ACCHS.

If all of the admission requirements are met.
I authorise ACCHS to contact me by SMS, Email or phone.
I authorise ACCHS to verify any information I have provided on this form.
I give ACCHS permission to obtain official records / confirm details from a previous educational institution attended by me listed on this form.
I have read and understood all of the information on this form.
I am aware of my obligation to advise of any changes to my contact details within 7 days including a change to my next of kin / emergency contact / phone number / address or email.
I am aware of my obligation to pay outstanding fees and understand non-payment of fees can lead to cancellation of my course enrolment by ACCHS.
I am aware I must abide by visa conditions throughout my enrolment period in Australia including maintaining attendance and course progress/
I understand living costs in Australia may be higher than my home country.
I understand Tuition and Non-Tuition fees may change during my course.
I have been provided with access to pre-enrolment information including the ACCHS International Student Handbook & marketing information containing: entry requirements for the course including English language, and academic requirements, work experience and course credit/RPL applicabl; any required work based training course content, duration & holiday breaks, qualification(s) on completion, modes of study and assessment methods; ACCHS campus and locations, ACCHS general description of facilities, equipment, learning and library resources; details of any arrangements ACCHS has with any other organisations to provide the course; course related fees (Tuition and non-Tuition); the ACCHS Refund, Complaints and Appeals, Deferment, Suspension and Cancellation Policies; A description of the ESOS Framework including the ESOS Act (as amended) and the National Code 2018; Costs of living in Australia, Accommodation options, and obligations of schooling for any school aged dependents I may have.
I acknowledge and agree that ACCHSmay share personal information with The Australian Government and designated authorities and, if relevant, the Australian Skills Quality Authority (ASQA), the ESOS Assurance Fund Manageror the Tuition Protection Service (where applicable) and their authorised auditors.
I acknowledge and agree that ACCHS may advise the Department of Home Affairs (DHA) and Agent about personal information, changes in the student enrolment and breach of any student visa relate to attendance or progress.
I am aware I can obtain additional copies of the International Student Handbook, Policies, Procedures and Marketing Information from the ACCHS website: www.acchs.edu.au

Applicant's Signature*

Documents Required

Copy Passport
Certified copies of Previous Qualificatons
Evidence of English Language level
Copy of visa (if applies)
Copy of OSHC
Additional support information (if applies)
Release Letter (if applies)

Upload Documents*

ENROLMENT FORM

STUDENT DETAILS

CONTACT DETAILS

OVERSEAS STUDENT HEALTH COVER (OSHC)

NATIONALITY/CITIZENSHIP

HIGHEST LEVEL OF EDUCATION ACHIEVED

ENGLISH LANGUAGE

COURSE SELECTION

TO BE COMPLETED IF YOU ARE ALREADY STUDYING OR HAVE COMPLETED A PREVIOUS COURSE IN AUSTRALIA

STUDENT DECLARATION AND SIGNATURE