Application Form (AUCD Award)

Application Form (AUCD Award)

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

For the Undergradute Certificates, Diploma of Counselling, Diploma of Ministry, Bachelor of Ministry, or Graduate Diploma of Ministry, 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 (If you have One name, please type your name here)
PREFERRED NAME
MARITAL STATUS *
PREVIOUS FAMILY NAME (if applicable)
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. This cannot be a screenshot.
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PRIMARY PHONE*

Country CodePhone Number
PERMANENT HOME ADDRESS (Billing: where you live permanently - if you are an overseas student or temporary visa holder, this is your home address in your home country)*

Address Line 1

Address Line 2

CityState / Province / Region

Postal CodeCountry
IS YOUR TERM ADDRESS THE SAME AS YOUR PERMANENT ADDRESS?
TERM ADDRESS (Residential: where you will be staying while studying)

Address Line 1

Address Line 2

CityState / Province / Region

Postal CodeCountry

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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ARE YOU OF ABORIGINAL AND/OR TORRES STRAIT ISLANDER DESCENT?
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?
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
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
Withdrawal and Refund

Students may withdraw from courses without academic penalty only if notice of withdrawal is submitted in writing to the Registrar by 4:00pm on the Census Date applicable to the unit/s in question. If withdrawal occurs up to 4:00pm on the Census date the tuition fee will be refunded however, a withdrawal penalty may be charged to the student. Beyond this time, tuition fees will not be refunded unless there are exceptional circumstances. If the Australian University College of Divinity Member Institution defaults in delivery of subjects or courses the arrangements set out in the Australian University College of Divinity Refund Policy apply. To view the AUCD Withdrawal and Refund Policy please select the link below: https://scd.edu.au/resources/refund-and-withdrawal-policy/
CONSENT*

I understand & accept the AUCD Withdrawal & Refund Policy.
Privacy Legislation

Australian University College of Divinity (AUCD) and its Member Institutions require the information requested of you in the 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 the AUCD and its Member Institutions 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 the Department of Education and Training, Centrelink, and the Department of Home Affairs, Tuition Assurance Scheme, ESOS Assurance Fund Manager, Graduate Careers Australia, Insync Surveys PL, QILT) in order to provide you with high quality education services and assess your academic progress or suitability. From time-to-time Australian University College of Divinity (AUCD and its Member Institutions will take photos of students for a variety of purposes including, publications and on the internet. Your permission is required before we can use your image in these public domains. You can request access to your health and personal information by contacting the Privacy officer. To view the AUCD Privacy Policy please select the link below: https://scd.edu.au/resources/privacy-policy/
CONSENT*

I understand & accept the AUCD Privacy Legislation
Academic Integrity

All students are expected to treat academic integrity as a framework that is integral to their own authentic learning experience, a means for pursuing excellence in their academic development, and as essential to maintaining the high value of the AUCD award in which they are enrolled. All students are expected to embrace the opportunity to produce original work that demonstrates their learning. All students are expected to follow all rules, regulations, directions, requirements or guidelines governing the production of academic work. All students are expected to seek help if necessary, to ensure that standards of academic integrity are maintained in their own behaviour and that of their fellow students, as exemplified by the AUCD faculty and staff. All students are expected to participate in any training or educational activities that support the maintenance of academic integrity. To view the AUCD Academic Integrity Policy please select the link below: https://scd.edu.au/resources/academic-integrity-policy-2/
CONSENT*

I understand & accept the AUCD Academic Integrity Policy.
Declaration

I understand that I may be contacted by Australian University College of Divinity if the information in my admission forms given to PBC is no longer current or requires further clarification. I wish to be considered for entry to the program I have nominated.I declare that all information I have provided herein is true and accurate to the best of my knowledge.
CONSENT*

I understand & accept the AUCD Declaration.
Signature*

Clear
DATE*
Should be Empty:

Application Form (AUCD Award)

COURSES

Previous Education

Secondary Level

Tertiary Level Studies

Further Details

English Proficiency

Financial Information

Church Information

Reference Information

Next of Kin

Declarations

Withdrawal and Refund

Privacy Legislation

Academic Integrity

Declaration