Application form

Please print in BLOCK LETTERS

Personal details (as shown in passport) Previous studies

Secondary Education
Title: X Mr Ms Mrs Miss Other
Family name: Name of qualification: GCSE A Level
FAROOQ
Given names: Name of school/institution: Cadet College Hasanabdal
Preferred name: AHMAD Country/state: Pakistan

Date of birth: 26 / 01 / 2001 Year completed (or expected to complete): 2019

Gender: XMale Female
Passport expiry date: Post-secondary/tertiary education:
Passport number:
DD / MM / YYYY
Name of qualification:
Country of birth: PAKISTAN
Name of school/institution:
Citizenship: PAKISTAN
Country/state:
Are you a citizen or permanent resident of Australia? Yes X No
If ‘yes’, please provide evidence of citizenship or residency (e.g. a certified Year completed (or expected to complete):
copy of your birth certificate, passport, citizenship certificate or visa). Will you be applying for exemptions/credits? Yes No
If verification is not supplied, fees and conditions for international students If so, provide copies of relevant academic transcripts detailed syllabus
will apply. and a completed Application for Exemption form, available at
Have you previously studied at ECC or PIBT? Yes X No edithcowancollege.edu.au/documents-and-forms.
If so, please provide your student ID number: Have you ever been expelled/terminated/excluded from study by a school,
Do you grant ECC permission to provide your parent or guardian listed college, or university in Australia? Yes X No
below with any information pertaining to your application to study, ongoing If ‘yes’, please provide evidence
academic progress, results and attendance? X Yes No
Have you ever been refused a visa to enter Australia? Yes X No
If yes, please provide evidence
Contact details
Applicant’s contact details (Compulsory) Employment history
If you believe you have employment experience that is relevant to the
Email address: 7 2 4 1 @ c c h . e d u program you are applying for, please attach a CV and references.
. p k Program selection
Address in Australia (if known):
English program
Academic Course start date: DD / MM / YYYY
Suburb: Number of weeks: (in multiples of 10)

State: Postcode: Diploma program

Business Stream: (mandatory)
Telephone: Mobile:
Communications
and Creative Industries Stream: (mandatory)
Address in home country:House # 9 H Block Vehari Hotel Management Stream: (mandatory)
Punjab Pakistan Science (Computing/IT) Stream: (mandatory)
Science (Engineering Studies) Stream: (mandatory)
Suburb: Science (Health Studies) Stream: (mandatory)
State: Punjab Postcode: 61100 Please specify when you prefer to begin your studies:
Country: Pakistan Year: 2020 February June October

Telephone: Mobile: Post Graduate Qualifying Program (PQP)

Master: _____________________________________ (mandatory)
Parent’s/guardian contact details (Compulsory)
Please specify when you prefer to begin your studies:
Family name: Muhammad Year: February July
Given names: Farooq
Relationship to applicant: Father
Telephone: 92 3456789118
Email address: farooqh09@gmail.com

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 Request for disability support Declaration
Do you have a disability that may affect your studies? Yes X No I declare the information I have supplied on this form is, to the best of my understanding
and belief, complete and correct. I understand that giving false or incomplete information
If ‘yes’, please specify: Hearing Vision Mobility may lead to my application being refused or my enrolment cancelled. I have read and
Medical Learning Other (please specify): understood the relevant program information in this brochure and/or on the ECC website
and I have sufficient information about ECC to enrol. I understand that the pathway may
Please attach relevant information to help ECC determine what learning
lead to future studies at ECU, subject to ECU’s entry requirements.
assistance (if any) you might require.
I understand that ECC fees may increase. I accept liability for payment of all fees as
explained in the ECC brochure and/or website, and I agree to abide by the Refund policy
International students only as outlined in edithcowancollege.edu.au/policies. I have read the information about
English proficiency living expenses on page 9 and I understand that living expenses in Australia may be
higher than in my own country. I confirm that I am able to meet these expenses. I have
(Please tick and attach documentary evidence where applicable) understood and I accept the Enrolment Terms of Offer at edithcowancollege.edu.au/
English is my first language policies. I understand that ECC may, by written notice, vary its conditions as may be
necessary to comply with any law or regulation, or amendment of any law or regulation,
X English was the language of instruction during my secondary school
of the Commonwealth of Australia or the State of Western Australia. I give permission
studies and I gained a satisfactory pass in final-year English
for ECC and ECU to obtain official records from an educational institution attended by
(results attached). me, and to supply my contact details and any relevant official records to educational
I have taken an IELTS, TOEFL, or PTE test, and attached my results to institutions I am eligible to gain admission to. I authorise ECC to provide my personal
information, including my contact details and enrolment details, to third parties in
this application.
accordance with ECC’s Privacy policy. These third parties include ECC representatives
I have obtained a satisfactory mark or score in another examination (agents) acting on my behalf; ECU (to facilitate progression from ECC to the next stage
or test acceptable to ECC (e.g. completion of at least the first year of my studies); sponsors and Navitas Limited and its affiliates (to communicate pathways
of a post-secondary/tertiary course at a college or university where and services offered by Navitas Limited and its related companies). In the event of
the language of instruction was English). circumstances requiring urgent medical care and where it is not possible to contact next-
of-kin, ECC is authorised as a matter of urgency to seek appropriate medical care.
IELTS / TOEFL / PTE score:
International students only: I understand that it is my responsibility to maintain valid
Other English test: Score: Overseas Student Health Cover (OSHC). I also understand that if I am no longer enrolled
at ECC, my OSHC membership can be transferred. I understand that if I have applied
Are you currently enrolled in an ELICOS school? Yes No through an approved ECC/ECU agent, all correspondence relating to my application will
If ‘yes’, please provide name of school: be forwarded to that agent. In the circumstances of any suspected breach of my student
visa conditions, I authorise ECC to provide my personal information, including my contact
details and enrolment details, to the Australian Government’s designated authorities, and
Overseas Student Health Cover (OSHC) the Tuition Protection Service (TPS).
ECC will provide all international students with an OSHC policy provided Health Protection: I give permission for ECC to obtain records and information from
by Allianz Global Assistance, unless advised otherwise my current OSHC provider (if applicable). I also agree that ECC is able to exchange
information with my OSHC provider with respect to meeting my visa requirements and
Would you like ECC to arrange OSHC for you with Allianz Global maintaining my OSHC cover.
Assistance? X Yes No I understand that any conditions concerning an offer of admission will be contained in
my letter of offer from ECC, which I will be required to read and sign.
Type of cover
X Single - covering only the Overseas Student
Applicant’s signature:
Dual Family - covering the Overseas Student, and either one adult
(must be the same signature as in your passport)
spouse or recognised de facto partner or one or more children or step-
children under the age of 18 years who are not married
Multi Family - covering the Overseas Student and more than one
dependent, which can only include one adult spouse or recognised de Date: DD / MM / YYYY
facto partner and one or more dependent children
If you are under 18 years of age, your parent or guardian must also sign this
If you already have OSHC, please provide details of your cover below: application form.
OSHC provider name: Parent’s/guardian’s signature:
OSHC number:
OSHC expiry date: DD / MM / YYYY
Date: DD / MM / YYYY
Visa *Unsigned applications cannot be processed. Agents cannot sign on an
applicant’s behalf.
Which type of visa will you be applying for?
X Student Tourist Working Holiday Visa
Other (please specify):
Application submission
This application form has been submitted in:

Sponsored students only City: lahore Country: PAKISTAN

Name of sponsoring organisation:

Postal address for applications
Type of sponsorship (e.g. tuition fees, living expenses):
Admissions Office
Edith Cowan College
Other information Edith Cowan University, Building 31 Joondalup Campus
270 Joondalup Drive Joondalup WA 6027 Australia
How did you first learn about ECC? You may tick more than one.
Exhibition/seminar T +61 8 6279 1100 F +61 8 6279 1111
Newspaper/magazine E info@edithcowancollege.edu.au W edithcowancollege.edu.au
Recommended by a friend/relative — if so, is your friend/relative an
ECC student? Yes No Or through an ECC representative:
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X Recommended by an education agent

Representative’s stamp
Internet, please specify:
Other (please specify):

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