APPLICATION FORM

Application ID s3741062

1 Personal information
Have you previously applied for a place or been enrolled in a program at RMIT?
✔ Yes Student ID s3741062

Please fill in your family name, middle name(s) and given name as Date of birth (dd/mm/yyyy)
stated in your ID card/passport
3 0 0 9 1 9 9 9
Family name Tran

Middle name(s) Nghia Gender

Given name Bang ✔ Male Female Other

Nationality
✔ Vietnamese Other (please specify)

2 Contact information
Permanent home address Postal adress ✔ As permanent home address
House number and street name 88/2b Pham Dang Giang House number and street name

Ward Binh Hung Hoa Ward

District or town Binh Tan District or town
Province or city Ho Chi Minh City Province or city

Personal contact details

Mobile 0397958301 Occupation
Home phone Company
Email nghiabangtran@yahoo.com.vn

Family contact details

I agree for RMIT to contact the below nominee: ✔ In an emergency ✔ Release of study progress
Contact’s full name Tran Van Thang
Relationship Father Occupation
Mobile 0967429930 Email nghiabangtran@yahoo.com.vn

In case of emergency, please specify which hospital should be chosen (tick ONE box only)
Hospital designated by Student preference (please indicate hospital) Hoan My Hospital (4A Hoang Viet, Ward 4, Tan Binh District, HCMC)
campus medical clinic

3 Academic records
College or university RMIT University
Program name International Business
Program level Bachelor Study location 702 Nguyen Van Linh, Tan Hung Ward, District 7, HCMC
✔ Completed Duration from (mm/yyyy) 08/2017 to (mm/yyyy) 05/2021

Other college or university

Program name
Program level Study location
Completed Duration from (mm/yyyy) to (mm/yyyy)

Other college or university

Program name
Program level Study location
Completed Duration from (mm/yyyy) to (mm/yyyy)

Have you previously been expelled from RMIT Vietnam or any other college or university? (leave blank if not applicable)
Yes College or university
Reason
 4 Registration for English program (for non-native English speakers)
Your most recent English language certificate RMIT Certificate
Test date Result

Register for English for University IELTS Test Preparation

Level Commencement date

5 Registration for postgraduate program

Program Campus Semester
Master of Business Administration ✔ Saigon South Feb 20
✔ Master of International Business Hanoi City Jun 20
Master of Global Trade ✔ Oct 20 21

6 Special offer
Family discount (5%)* ✔ Alumni discount (10%) for RMIT Vietnam or any Australian universities
Family member’s student ID Program completed International Business
*Applicant must provide notarised copy of birth certificate/marriage certificate. Campus Saigon South Campus

Fixed fee (applicant will have to submit a seperate form)

7 Equitable Learning service

RMIT Vietnam is committed to providing an accessible and supportive learning environment for all students. If you have special requirements,
please indicate the type of support you need below:
Hearing Mobility Medical Learning

Vision Other (please specify)

8 Applicant declaration

Please read and sign the following declaration. This application is not valid unless signed and dated.

I declare that, to the best of my knowledge, the information supplied in this application and supporting documentation is correct and complete. I will
notify RMIT Vietnam immediately of any change to my personal details.

I acknowledge that the provision of incorrect information or the withholding of information or documentation relating to my application may result in
the cancellation of any offer or enrolment by the University.

I understand that the release form allows information, including my personal details and information about my academic and financial records, to
be released.

This permission is granted provided the University releases information only for the reason(s) nominated and only after proper identification has
been made.

I understand that RMIT Vietnam may be required to release information about my status as a student to other bodies as part of its legal requirements
within Vietnam and Australia.

I understand that RMIT Vietnam reserves the right to discontinue or alter any program, course/subject, fee, admission requirement, staffing or other
arrangement without prior notice.

Applicant’s signature

Full name Tran Nghia Bang

Date (dd/mm/yyyy) 06/04/2021

FOR OFFICE USE ONLY (Applicant does not fill in this section) Selection officer’s Approval
Unconditional Conditional on English
Other
Received by PA on Received by Admissions on Received by selection officer on

PA’s stamp and signature Admissions’ stamp and signature Selection officer’s stamp and signature