International Student Application Form

1. Complete all sections using CAPITAL letters

2. Attached certified supporting documents and a copy of your passport
3. Send your application to:

Add:

NMIT International Office

20 Otter St, Collingwood, VIC, 3066
Australia

Tel:
(+61 3) 9269 1666
Fax:
(+61 3) 9269 1669
Email: international-admissions@nmit.vic.edu.au

Personal Details
Family Name (as shown in passport) .................................................................................................................................................................................
Given Names ......................................................................................................................................................................................................................
Date of Birth (DD/MM/YY) ........................................................................
Passport Number......................................................................................

Male

Female

Nationality / Citizenship.............................................................................

Contact Details
If you are currently living outside Australia, please provide your overseas address. If you are already living in Australia, please provide your
Australian address.
Number and Street .............................................................................................................................................................................................................
............................................................................................................................................................................................................................................
Suburb / Town / Country............................................................................................................................ Postcode / Zipcode ......................................
Home Phone Number ...............................................................................

Mobile Phone Number ..............................................................................

Email Address ....................................................................................................................................................................................................................

Course Preferences
Name of Course

CRICOS Code

1. .................................................................................................................................................................................

.........................................

2. .................................................................................................................................................................................

.........................................

3. .................................................................................................................................................................................

.........................................

Semester / Intake

February

ELICOS English Language Course

July

Year ......................

Number of Weeks ........................

Other Intake ............................

Commencement Date ..........................

Visa
Do you hold a current Australian visa?

Yes

No

If YES, what is the Type of Visa? ........................................

Visa Subclass .......................................

Visa Expiry Date .......................................

Health Cover
Do you have current Overseas Student Health Cover (OSHC)?

Yes

No

If YES, what is your Membership Number? ..............................................................................................

If NO, what type of OSHC will you require?

CRICOS Provider No: 00724G

www.nmit.edu.au

Single

Family

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OSHC Expiry Date ...................................

I do not require OSHC

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Edition 12: 20/10//2011

Previous NMIT Studies

Have you previously been enrolled at NMIT?

Yes

No

If YES, please provide your student number ............................................

English Language Level

Provide details and documentation confirming your English language level
I have taken a recognised English language test in the last two years (e.g. IELTS, TOEFL, Pearson, Cambridge).
Name of Test ............................................................................................

Score .......................................

Date of Test .......................................

I have successfully completed an English course in Australia

I have completed studies where English was the language of instruction
English is my first language
I will complete an English course or take a recognised English language test on .....................................

Previous Studies
Are you currently studying in Australia?

Yes

No

If YES, please provide copies of your Confirmation of Enrolment (CoE) documents and complete the details below
Name of Course ..................................................................

Institution ..........................................

Date of Completion ......................................

List details of your previous education and attach documentation including certified copies of full academic transcripts. Documents not in English
must be accompanied by certified translations.
Name of Qualification

Institution

Country

Year Finished

............................................................................

...............................................

................................................

.........................................

............................................................................

...............................................

................................................

.........................................

If you believe you have relevant work experience, attach details and documentation (e.g. employer reference)

Agent Details
Please complete this section if you are using an education agent or representative.
Agent Name........................................................................................................................................
Agent Address ....................................................................................................................................
Agent Telephone ................................................................................................................................

Agent
Representative
Stamp

Agent Email ........................................................................................................................................

Declaration
I declare that the information provided on this form and supporting documentation is true and correct. I have read and understood the refund policy and terms and
conditions of enrolment in the NMIT International Course Guide or at www.nmit.edu.au. I hereby give permission to NMIT to see and access all the details of my
current visa through the Visa Entitlement Verification Online (VEVO) system. I acknowledge that the provision of incorrect information or documentation or the
withholding of information or documentation relating to my application may result in the cancellation of my enrolment.

Applicants Signature.......................................................................................................................

Date..........................................................

(If applicant is under the age of 18, the application must also be signed by the applicants parent or guardian.)

CRICOS Provider No: 00724G

www.nmit.edu.au

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P/IO/F/4/561A
Edition 12: 20/10//2011