Vanuatu Agriculture College

Self Reliance through Agri-Business

Complete this form with a blue or black pen

When you see this paperclip, it means YOU MUST PROVIDE DOCUMENTS AS EVIDENCE. (See page 3 for the checklist of acceptable documentation) Date of Birth

Courses Offer Year 12 or Cert 2 Certificate III in Animalrelevant to ScienceLivestock or 3 years (Animalrelevant work Husbandry)experience Year 12 or Cert 2 in Certificate III174,400VT14 Weeks in Agriculture Agriculture or 3 (Plant years relevant work Science) experience Certificate IVYear 13 or Cert 319 Weeks 231,300VT in relevant to

Duration Course Fee* 147,800VT12 Weeks

Livestock/Agricultu re or 3 years relevant work

experience Certificate IVYear 13 Science or242,800VT20 Weeks in Animal Cert 3 relevant to

Science (Livestock Husbandry and Marketing) Certificate IVYear 13 Science or in AgricultureCert 3 relevant to (Plant Agriculture or 3 Science) years relevant work experience *Course fee includes accommodation and meals

Livestock or 3 years relevant work

Which one is the best and fast way to contact you? Tick appropriate box

Payments can be made through the bank, using the details below:

(Scan and email to vacinfo@vanuatu.gov.vu)

1.Personal Details - for proof of your identity (Attach Birth Certificate)

7.Emergency Contact Provide details of a person who can be contacted in case of an emergency (parent, spouse, other family member)

8. Employment Details (if you are still employed)

Attach copies of qualifications and transcripts

11. Work experience (for those with work experience)

Have you done some work experience related to Agriculture?

This question asks about difficulties you may have, and supports you may need.

Provide details of work experience on table below (Use extra sheets of papers if needed) TaskName ofPeriod Position (start-end) company

Do you have a lot of difficulty with any of the following?

Seeing Hearing Walking or climbing steps Remembering or concentrating Self-care (e.g. washing all over, dressing) Communicating in your usual language

Attach recent CV, Reference, Work reports and qualification obtain from short courses, workshops, etc.

12. What course are you applying for? (Write what course you are interested in - see page 1 for help)

13. How will you be financing your course here at

14. Reason for undertaking this course. Of the following categories, select the ONE that best describes your main reason for undertaking this course:

What is your Highest Level of qualification? Tick the appropriate boxes

Secondary Education Tertiary Education

Secondary Education Yr. 12Yr. 13Yr.14

To get a job To develop my existing business To start my own business To try for a different career To get a better job or promotion It is a requirement of my job I want extra skills for my job To get into another course of study For personal interest or self-development Other (please specify)

15. Use of personal information All personal information collected by VAC is used only for the purposes for which it was provided. VAC takes all reasonable steps to protect the security of personal information it holds whether it is stored in electronic or hard copy form. Access is available to the person whose information is held by VAC

Medical certificate (Practical, work, allergic) Work experience references if applicable

I understand that the information

Return your completed form to the address below.

provided here is to be used in line with the privacy statement above and should VAC accept my enrolment, my success will depend upon my own efforts. I declare that I have read and understood

all the course information that VAC has provided to me. I confirm that all information I have submitted is true, correct and complete. I authorize VAC to verify my academic and professional qualifications and employment. I am aware that, if I am selected for an interview, I am required to attend the interview and participate in any assessments that are part of the interview, before I will be considered for enrolment in the course of my choice.

Vanuatu Agriculture College P.O. Box 218 Luganville, Santo Sanma Province

Tel: (678) 36606 Email: vacinfo@vanuatu.gov.vu

I am aware of all the course costs and I am able to meet these costs for the duration on the course.

I have enclosed the required document:

For Official Use Only: Admission officer compile application form that have been received. Please check that the applicant has satisfied the following conditions: (Tick box as appropriate Application form has been completed Copies of all relevant certificates and results Birth certificate (Standard) Medical Certificate CV, work reports, qualification obtain from short courses

Completed and signed application form Copies of all relevant school and qualification certificates and results

The Admissions Committee: Approved successful applicant Inform short listed applicant who are eligible for special entry to continue with RPL(A) process Invite short listed applicant for an interview and LLN assessment Select successful applicant This application is AcceptedRejected Pending review(Tick)