Application Form (PBC Award)

Application Form (PBC Award)

Personal Details - Page 1 of 10
This is the application form for the following courses: Undergradute Certificates, Diploma of Counselling, Diploma of Ministry, Bachelor of Ministry, and Graduate Diploma of Ministry.

For the Bachelor of Counselling, Graduate Diploma of Counselling, or any Masters courses, please fill out this application form instead.
DID YOU ENGAGE THE SERVICES OF AN AGENT IN APPLYING TO PBC? *
WHAT WAS THE NAME OF THE AGENT?
WHAT WAS THE NAME OF THE AGENCY?
Personal Details*

TitleFirst NameMiddle NameLast Name
PREFERRED NAME
MARITAL STATUS *
PREVIOUS FAMILY NAME
DATE OF BIRTH*

DayMonthYear
Date
GENDER*
EMAIL*
example@example.com
DIGITAL PHOTO*

Please upload a photo of yourself (head and shoulders only) for your student card.
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PRIMARY PHONE*

Country CodePhone Number
PERMANENT HOME ADDRESS*

Address Line 1

Address Line 2

CityState / Province / Region

Postal CodeCountry
IS YOUR TERM ADDRESS THE SAME AS YOUR PERMANENT ADDRESS?
TERM ADDRESS

Address Line 1

Address Line 2

CityState / Province / Region

Postal CodeCountry
ARE YOU OF ABORIGINAL AND/OR TORRES STRAIT ISLANDER DESCENT?

Personal Details (Continued)
CITIZENSHIP*
Which option best describes your Australian visa situation?
Other Visa
Visa Evidence

Please upload evidence of your current visa (VEVO Visa details check issued within the last 6 month)
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COUNTRY OF BIRTH*
Year of arrival into Australia
BIRTH CERTIFICATE OR PASSPORT*

An original or certified copy of your birth certificate or passport will have to be sighted by the college.
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SECONDARY ID*

This can be a driver's license, learner's permit, Medicare card, Veteran's card, other photo ID, etc.
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PLEASE UPLOAD YOUR TESTIMONY*

This is a 1-2 page document (Maximum 600 words) detailing your testimony, including how you became a Christian, and why you believe that the Lord would have you train for Christian life and service at PBC. Please use a font style that's easy to read in font size 12. Please name your file: Lastname_Firstname_Coursename_testimony.doc OR Lastname_Firstname_Coursename_testimony.pdf
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DO YOU SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME?*
WHAT LANGUAGE DO YOU SPEAK AT HOME?
Do you have any special skills or interests?
Ex: Playing an instrument, hobbies, singing, welding, etc.
How did you hear about us?
Ex: Word of mouth, social media, Sonshine FM, etc.
DO YOU HAVE A DISABILITY, IMPAIRMENT OR LONG TERM MEDICAL CONDITION WHICH MAY AFFECT YOUR STUDIES?*
PLEASE INDICATE:

HearingLearningVisionMedicalMobilityOther
OTHER CONDITION
PLEASE LIST ANY MENTAL HEALTH CONCERNS (IF NONE, PUT N/A)*
WOULD YOU LIKE TO RECEIVE ADVICE ON SUPPORT SERVICES, EQUIPMENT AND FACILITIES WHICH MAY ASSIST YOU?

Courses
WHICH COURSE ARE YOU SEEKING ADMISSION INTO?*
WHEN DO YOU WISH TO BEGIN STUDY?*
e.g. Trimester 1, 2024
HOW ARE YOU INTENDING TO STUDY?*
USI (Unique Student Identifier) *
If you do not already have a USI, please go to: www.usi.gov.au to obtain one. You will need this in order to submit your application. If you are outside of Australia, put "0" in this field. You will need to obtain one upon arrival into Australia.
HAVE YOU PREVIOUSLY STUDIED AT PBC?*
WHEN?
Course Admission
WHAT IS YOUR HIGHEST LEVEL OF EDUCATION ACHIEVED?*
ON WHAT BASIS ARE YOU SEEKING ADMISSION?*

High School Certificate or equivalentSecondary Education, TAFE or equivalentHigher Education CourseProfessional QualificationMature AgeSpecial Entry
TRANSCRIPTS AND CERTIFICATES

Please provide a colour PDF copy of your transcripts and your certificates of completion (if you have them).
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EVIDENCE

Please provide evidence of your professional qualification
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EVIDENCE - MATURE ENTRY

Your STAT score is required, plus a copy of your passport or birth certificate
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SPECIAL ENTRY

Please provide your resume and any non-accredited certificates
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Previous Education
Secondary Level
SCHOOL ATTENDED*
STATE*
POSTCODE
WHAT IS YOUR HIGHEST COMPLETED SECONDARY SCHOOL LEVEL? (OR EQUIVALENT)*
IN WHAT YEAR DID YOU LEAVE/GRADUATE FROM SECONDARY SCHOOL?*
ATAR/ UAI / TER / OP SCORE
NAME OF THE TOWN/SUBURB WHERE YOU LIVED IN YOUR LAST YEAR OF SECONDARY SCHOOL
POSTCODE
COUNTRY OF STUDIES
LANGUAGE OF STUDIES
ACADEMIC RECORD OR AWARD

Please include a copy of your academic record or award.
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Tertiary Level Studies
INSTITUTION STUDIED AT
SECOND QUALIFICATION: INSTITUTION STUDIED AT
Credit for Previous Study
WOULD YOU LIKE TO APPLY FOR CREDIT FROM PREVIOUS STUDY?
If unsure, please contact the college
ACADEMIC TRANSCRIPT AND CERTIFICATE FOR CREDIT TRANSFER

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Further Details
ARE YOU CURRENTLY STUDYING ELSEWHERE?*
INSTITUTION
COURSE NAME
COURSE MODE
WHAT WAS YOUR MALE PARENT/GUARDIAN’S HIGHEST EDUCATIONAL ATTAINMENT?*
WHAT WAS YOUR FEMALE PARENT/GUARDIAN’S HIGHEST EDUCATIONAL ATTAINMENT?*
English Proficiency
IS ENGLISH YOUR FIRST LANGUAGE?*
If English is not your first language, you may be required to complete an IELTS test.
HAVE YOU COMPLETED AN ENGLISH LANGUAGE TEST?*
TEST NAME
TEST SCORE
TEST DATE

DayMonthYear
Date
TEST RESULTS

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Financial Information

Note: Tuition fees are required before each trimester.
HOW DO YOU GENERALLY PLAN TO PAY FOR YOUR STUDY?*

Cash/ChequeCredit Card (Visa)Fee HelpCredit Card (MasterCard)Bank TransferOther
Other
HAVE YOU USED HECS/FEE-HELP BEFORE?*

Church Information
THE CHURCH THAT YOU ATTEND*
Pastor's Name*

First NameLast Name
PERIOD OF ATTENDANCE*
CHURCH INVOLVEMENT*

Reference Information

Please nominate 2 non-related Christian referees who have known you for at least 2 years.
FIRST NAME*
LAST NAME*
Phone Number*

Country CodePhone Number
Reference EMAIL 1*
example@example.com
FIRST NAME*
LAST NAME*
Phone Number*

Country CodePhone Number
Reference EMAIL 2*
example@example.com

Next of Kin
FIRST NAME*
LAST NAME*
RELATIONSHIP TO YOU*
Phone Number*

Country CodePhone Number
EMAIL (Next of Kin)*
example@example.com

DO YOU WANT TO APPLY TO USE OUR ACCOMMODATION?*
Please submit an accommodation application form via PBC website. Accommodation is subject to availability.

Declarations - PBC award applicant only
Withdrawal and Refund

Students may withdraw from courses without academic penalty only if notice of withdrawal is submitted in writing to the Registrar by 4pm on the Census Date. Withdrawal prior to 4pm on the Census date will ensure refund of the tuition fee. Tuition fee will not be refunded beyond this time. See the Perth Bible College Refund Policy for further details.
CONSENT*

I understand and accept the withdrawal and refund arrangements of Perth Bible College
Privacy Legislation

Perth Bible College requires the information requested of you in this form in order to provide you with education services and to cater for particular student’s needs. If you do not provide all the relevant information, we may not be able to provide such services and to assess your academic progress.Please also note that Perth Bible College may provide your personal information and sensitive information to third parties (e.g. educational institutions such as universities, colleges and accreditation bodies and Australian government bodies such as DEEWR, Centrelink and the Department of Immigration and Citizenship, Tuition Assurance Scheme, ESOS Assurance Fund Manager) in order to provide you with education services and assess your academic progress or suitability. You can request access to your health and personal information by contacting the Privacy Officer.
CONSENT*

I understand and accept the privacy legislation.
Declaration

I agree with the PBC Statement of Faith. I undertake to give the utmost attention to my studies, and to carry out such duties as are allotted me, to live for others at all times, and to abide by the College guidelines and policies at all times. I wish to be considered for entry into the program that I have nominated. I declare that the information that I have provided herein is true and accurate to the best of my knowledge.
PBC Statement of Faith
CONSENT*

I agree
Signature*

Clear
DATE*
Should be Empty:

Application Form (PBC Award)

Course Admission

Previous Education

Secondary Level

Tertiary Level Studies

Credit for Previous Study

Further Details

English Proficiency

Financial Information

Church Information

Reference Information

Next of Kin

Declarations - PBC award applicant only

Withdrawal and Refund

Privacy Legislation

Declaration