www.academia21.

com
International Application Form
ACADEMIA AUSTRALIA
TEL +613 9671 4755 FAX +613 9600 4390
Email admissions@academia21.com
Student Details

FAMILY NAME: GIVEN NAME:

DATE OF BIRTH: / / GENDER: [ ] Male [ ] Female NATIONALITY:

DD/MM/YYYY

COUNTRY OF BIRTH: PASSPORT NO:

CURRENT ADDRESS: POSTCODE:

COUNTRY: CURRENT VISA TYPE: (if applicable)

EMAIL: MOBILE:
if you are in Australia

AGENT NAME: (if applicable)

Will you need to apply for a student visa?

[ ] YES, Choose an option in this section [ ] NO, Skip this

IF YOU APPLY FOR A STUDENT VISA, YOU NEED OSHC (OVERSEAS STUDENT HEALTH COVER). PLEASE ARRANGE OSHC FOR:

[ ] SINGLE [ ] COUPLE/DUAL OR [ ] FAMILY [ ] NO OSHC. I/my agent will arrange it.

Have you visited or studied in Australia previously? [ ] Yes [ ] No

Have you ever been refused a visa for entry into Australia or any other country? [ ] Yes [ ] No

Have you breached any visa conditions in Australia or any other country? [ ] Yes [ ] No

Have you done any English tests?

[ ] YES, SCORE: TEST NAME : [ ] YES, I’ve done the Academia VET Entry Test
EG. IELTS OR TOEFL

[ ] NO, but I do have an English certificate from another school. (Please include it with this form.) [ ] NO, I haven’t

CAMPUSES MELBOURNE CAMPUS [ ] BRISBANE CAMPUS [ ]

Course Details

399 LONSDALE STREET MELBOURNE VIC 3000 41 RAFF STREET, SPRING HILL QLD 4000
Course Details
COURSE NAME 1 : INTAKE DATE: / / NO. WEEKS:
DD/MM/YYYY ENGLISH courses only

COURSE NAME 1I : INTAKE DATE: / / NO. WEEKS:

DD/MM/YYYY ENGLISH courses only

COURSE NAME 1II : INTAKE DATE: / / NO. WEEKS:

DD/MM/YYYY ENGLISH courses only

Are you applying for any credit transfer? [ ] YES [ ] NO

If yes, please include your ACADEMIC TRANSCRIPT with this form.

Do you need any help when you arrive in Australia?

[ ] AIRPORT PICKUP

[ ] HOMESTAY PLACEMENT

[ ] NO, I do not need the above services

Once Academia International receives this form, we will issue a Letter of Offer and a Written Agreement which will include an invoice listing the costs
of your selected course(s).

I declare and understand that if I have withheld any personal information that is material to my application or provided any fraudulent
personal information regarding prior Visa History then I forfeit any rights to a refund of monies paid to Academia Australia.

Student Signature: Date: / /

DD/MM/YYYY

© Academia Australia / Academia International | registered trading names of Australian Academy of Vocational Education & Trades Pty. Ltd. | ABN 19 110 314 906 | CRICOS Provider Code 02634E | RTO Number 21595 Revision v. Jun 2017
INTERNATIONAL STUDENT APPLICATION PROCESS
www.academia21.com

Your course We respond and discuss options with:

enquiry Our liaison staff at ACADEMIA INTERNATIONAL
Career advisors
Registered Agents

You send us your

application form

Simply send us the application form

and documents to
admissions@academia21.com

We send you a letter of offer

and a written agreement

You sign on both sides of the letter of offer and the written agreement
and return it to us with payment confirmation

We send you eCOE

(Confirmation of Enrolment)

You apply for a student visa

through DIBP

If you have any issues with getting your visa in time,

please contact us as soon as you can to discuss any start date adjustments

Attend the induction on the

day as per the letter of offer

ACADEMIA AUSTRALIA
TEL +613 9671 4755 FAX +613 9600 4390
Email admissions@academia21.com
Start your studies at
Melbourne Campus
399 LONSDALE STREET, MELBOURNE VIC 3000
Brisbane Campus
41 RAFF STREET, SPRING HILL QLD 4000

© Academia Australia / Academia International | registered trading names of Australian Academy of Vocational Education & Trades Pty. Ltd. | ABN 19 110 314 906 | CRICOS Provider Code 02634E | RTO Number 21595 Revision v. Jun 2017