International Student Enrolment Application Form

International Student Enrolment Application Form
Student Details
Name*

Given NamesSurname
Home Phone

Area CodePhone Number
Mobile*

Area CodePhone Number
Email Address*
example@example.com
Preferred Contact Method*

EmailPhone
Residential Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Postal Address (if different to residential address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Passport Number*
Passport Expiry Date*

DayMonthYear
Date
Country of Issue*
Have you ever had a visa application refused or visa cancelled for Australia or any other country?*

YesNo
Have you ever been reported to Australia's Department of Home Affairs for failing to meet visa conditions?*

YesNo

Training Program Details
Program Code*
Program Name*
Program Cost*
Preferred Start Date*

DayMonthYear
Date
Preferred End Date*

DayMonthYear
Date

Unique Student Identifier (USI)
USI Number*
If you do not have a USI, do you give UMA College permission to apply for one on your behalf?*

YesNo
To raise a USI, we will need one of the following proof of identity evidences.
Visa Number
Expiry Date
Visa Type

Welfare
Do you require homestay?*

NoYes (How many weeks?)
Do you require airport pickup?*

NoYes (Insert Flight Number and Date of Arrival)
Do you require Overseas Student Health Cover?*

NoYes (Single or Family?)

Language
Proof of English Language*

IELTSTOEFL
Proficiency Level*
Have you studies in Australia before?*

YesNo
Details

Disability
Do you have a disability?*

YesNo
Please select your disability, impairment or injury.

HearingIntellectualPhysicalLearningMental IllnessAcquired

Reason For Study
Which best describes your reason for study?*

To get a job or better jobTo develop my existing businessTo start my own businessI want extra skills for my jobIt was a requirement of my jobTo try for a different careerFor personal interest or self-developmentOther

Emergency Contact
Name*

First NameLast Name
Relationship*
Home Phone

Area CodePhone Number
Mobile*

Area CodePhone Number

Marketing and Images
How did you hear about UMA College?*

Existing StudentAgentWebsiteSocial MediaOther
UMA College may from time to time send you details about future training opportunities or offers. Do you give permission to UMA College to contact you regarding this?*

YesNo
During training, photos or footage may be taken of you. Do you give UMA College permission to use these photos or footage for such things as improving training resources, promotional documents and reports?*

YesNo

Enrolment Application Fee

$300.00AUD Quantity

Total

$0.00AUD

Payment Methods

Credit Card

Apple Pay

By signing this form, I certify that the information provided is true and correct. I further certify that:
- I have reviewed the Learner Handbook supplied to me and have been informed about and accept my rights and obligations.
- I have reviewed and accept the Schedule of Fees and Payments and have been informed of the refund policy.
- I have reviewed the Course Brochure and have been informed of and accept the training and assessment services to be provided and the units of competency to be completed.
- I have reviewed the National VET Data Privacy Policy Notice provided in the Learner Handbook and acknowledge that Commonwealth and State or Territory government departments and authorised agencies will use my personal information in accordance
- I understand that UMA College may refuse my application or cancel my enrolment if any information is found to be incorrect or misleading.
- By submitting this form I agree that UMA College will independently verify the information supplied by me in this form and request further information or documentation as required.
- I authorise my booking agent to act on my behalf in all matters relating to this application and associated visa application.
Documents to attach with your application:
- Passport including photo page and signature page
- Evidence of English language proficiency
- Academic certificates/transcripts (translation needed if not in English)
After submitting your application, you will receive a response within two business days. Please note that UMA College may request additional information from you in support of your application.
Signature*

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International Student Enrolment Application Form

Student Details

Training Program Details

Unique Student Identifier (USI)

Welfare

Language

Disability

Prior Education

Reason For Study

Emergency Contact

Marketing and Images

Payment Methods