Protea International Student Application Form

Contact Details in Australia
Address

Address

Street Address Line 2

CityState

Postal / Zip Code
State
Post Code
Telephone/ Mobile
Email
example@example.com
Contact Details in Home Country
Address

Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Telephone/ Mobile
Email
example@example.com
Emergency Contact Details
Name
Phone Number
Address
Relationship to Applicant

Visa Information
Passport Number*
Expiry Date*

DayMonthYear
Date
Visa Type
Subclass
Expiry Date

DayMonthYear
Date
Passport issued by*
What type of visa will you be holding when you commence your studies?

StudentWorking HolidayTouristOther
Have you applied to become a permanent residence of Australia?

YesNo
If yes, date of application (dd/mm/yy)

DayMonthYear
Date
USI Information (Unique Student Identifier)
USI Number
If you do not have USI yet, please go to www.usi.gov.au to apply for it. If you are a new or continuing student undertaking nationally recognised training, you need a USI in order to receive your qualification or statement of attainment.

Education Agent Details

If you were referred by an Education Agent, please provide details below.
Agent Name/Business Name:
Agent Name/Business Name:
As an approved agent of PC, I am also certifying that I have verified all the original documents of the student. Signature

Clear
Privacy Notice
Under the Data Provision Requirements 2012, Protea College Pty Ltd is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER). Your personal information (including the personal information contained on this enrolment form and your training activity data) may be used or disclosed by Protea College for statistical, regulatory and research purposes. Protea College may disclose your personal information for these purposes to third parties. This practice is also required by the ESOS Act and the ESOS National Code 2018. including:
- School: if you are a secondary student undertaking VET, including a school-based apprenticeship or traineeship
- Employer: if you are enrolled in training paid by your employer
- Commonwealth and State or Territory government departments and authorized agencies
- NCVER
- Researchers
Personal information disclosed to NCVER may be used or disclosed for the following purposes:
- Issuing a VET Statement of Attainment or VET Qualification, and populating Authenticated VET Transcripts
- Facilitating statistics and research relating to education, including surveys
- Understanding how the VET market operates, for policy, workforce planning and consumer information, and
- Administering VET, including program administration, regulation, monitoring and evaluation
You may receive an NCVER student survey which may be administered by an NCVER employee, agent or third-party contractor. You may opt out of the survey at the time of being contacted.

NCVER will collect, hold, use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the VET data policy and all NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au).

Student Declaration and Consent
I full name , Declare that the information I have provided to the to the best of my
knowledge is true and correct.

I Consent to the collection use and discloser of my personal information in accordance with the Privacy Notice Above.
Applicant Name
Applicant Signature

Clear
Date

DayMonthYear
Date
Document Checklist

Passport bio-data pagesIELTS (or other English Language test) Results (if applicable)Evidence of highest academic qualificationsCopy of current Australian Visa (if applicable)OSHC Certificate (if applicable)
File Upload

Cancelof
Agent Name*
Agent Company Name*
Agent Email*
example@example.com
File Upload

Cancelof
Should be Empty:

International Student Application Form

Personal Details

Contact Details in Australia

Contact Details in Home Country

Emergency Contact Details

Visa Information

USI Information (Unique Student Identifier)

Language and Cultural Diversity

Previous Education

Disability

Employment

Study Reason

RPL/Credit

Transferring student information: (if applicable)

Education Agent Details

Agent Name/Business Name:

Privacy Notice

Student Declaration and Consent