New Enrolment

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Provider Id

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Provider Name

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Provider Country

Provider Email*

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Select the type of enrollment*

ELICOS
VET

Personal Details

Tell us something about yourself. Please make sure all the information you input is clear an correct. False or incomplete information might cause future issues with your visa.

Title

First Name*

Last Name*

Date of Birth*

Gender

Contact Details

Phone/Mobile Number

Email Address*

Student Number

USI Number (if applicable)

Other

Passport Number*

Passport Expiry Date

Country of passport

Are you applying:

Within Australia
Outside Australia

Have you overstayed your visa in the past?

No
Yes

You will be required to provide further information on next page

Do you hold a current Australian visa?*

No
Yes

Are you applying through an agency?

No
Yes

Have you got an Australian address?

No
Yes

Which DOHA Office would you like to apply?

Your current Australian visa

Please tell us what visa you currently hold.

What Australian visa you currently hold?

Student
Working holiday
Tourist

Visa Subclass

Visa expiry date

Overseas Address

Address of usual residence (overseas). You must provide overseas address of usual residence. In case the student is currently in Australia, an Australian address must be provided as well.

Street Address*

City*

State*

Post Code*

Country*

Address in Australia

If you live in Australia, your address while studying has to be provided as well.

Street Address

City

State/Territory

Post Code

Country

Entry requirements

You are required to have

You must be 18 years of age or above.
At least Year 11 or equivalent

Language & Culture

Tell us where are you from and what languages you speak.

Is English your first language?

No
Yes

What language/s do you speak?

English Proficiency

How good is your English?

Have you got any formal English testing?

No
Yes

Name of the test

Score of the test

Date of the test

Culture

Are you of Aboriginal origin or Torres Strait Islander?

None
Aboriginal
Torres Strait Islander

Agent's Details

Please provide following information about your agent.

Select your agent

Agent Email

Agency

Contact person

Contact Information

Phone number

Email

Previous Education

Where did you study before? What is your highest level completed?

What is your highest completed school level?*

Date completed*

Tertiary Education

Did you complete any tertiary education (colleges & universities)?

No
Yes

Level of qualification/s achieved*

Bachelor Degree or Higher
Advanced Diploma or Associate Degree
Diploma
Certificate I - IV

Proposed future studies:

Vocational
TAFE
University-Undergraduate
University-Post Graduate

Name of Institution:

Course commencement date:

Academic History

Overseas academic history

Organisation	Level achieved	Date finished

Australian academic history

Organisation	Level achieved	Date finished

Employment

Which categories best describe your current employment status?

Full time working employee
Part time working employee
Self employed – not employing others
Employer
Employed – unpaid worker in a family business
Unemployed – seeking full time work
Unemployed – seeking part time work
Not employed – not seeking employment

Occupation

Industry of Employment

Which categories best describe your main reason for undertaking this course?

Other Reasons

RPL & Credit Transfer

If you wish to apply for RPL or Credit Transfer, please visit our website for more information.

Do you wish to apply for RPL?

No
Yes

Do you wish to apply for credit transfer?

No
Yes

Disabilities

Do you consider yourself to have a disability, impairment or long-term condition?

No
Yes

Please specify

Other, please specify:

Do you have any special learning needs?

No
Yes

Please specify:

Course Selection

Do you want to apply for a ELICOS course in ?

No
Yes

Preferred course session

AM (Morning)
PM (Evening)

Preferred campus

Select your ELICOS course*

Please select any one of the course or combination of courses.

Preferred course session

Morning Option A: Mon-Wed 8:30am-4:15pm
Morning Option B: Thu-Sat 8:30am-4:15pm
Evening Option C: Mon-Fri 5:15pm-9:30pm

Preferred course session

Morning Option A: Mon-Wed 8:30am-4:15pm
Evening Option B: Mon-Fri 5:15pm-9:30pm

Preferred course session

Morning Option C: Wed-Fri 8:30am-4:15pm

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Course Duration ( in weeks )

Please enter a number from 4 to 58.

Select intake date

Weeks of holidays*

Please enter a number from 0 to 12.

Holiday Period 1 From

Holiday Period 1 To

Holiday Period 2 From

Holiday Period 2 To

Holiday Period 3 From

Holiday Period 3 To

Holiday Period 4 From

Holiday Period 4 To

Number of fee instalments

Select Your Courses

Do you want to apply for a vocational course in ?

No
Yes

Preferred campus

Select your vocational course*

Please select any one of the course or combination of courses.

Preferred course session

AM (Morning)
PM (Evening)

Preferred start date*

Other Courses

Do you plan to continue studying in Australia after completing your studies with ?

No
Yes

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Are you applying for ELICOS courses prior to studies at ?

No
Yes

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Which ELICOS courses are you applying to?

Institution	Commencement date	Course

You will be required to provide us with letter/s of offer from these institutions.

OSHC

OSHC (Overseas Student Health Cover) is one of your's visa requirements. Please specify what cover you require and for how long.

Do you require OSHC?

Yes
No

Type of your cover

Single
Family

Duration of your cover (in months)

Insurance Number

How did you hear about us?

How did you hear about ?

Other & Comments

Statement of Purpose

Please answer the questions down below. Make sure your answers are complete and honest.

Why do you want to study in Australia compared to studying in your home country?*

Why did you choose compared to other Australian educational providers?*

How will the program, you are applying to study with , benefit your current or future career path?*

Please describe what you intent to do upon completion of studies at ?*

Explain your current personal circumstances in your home country.*

Do you wish to bring family dependants (e.g. your spouse, children)?*

Yes
No

If yes, Enter the details below:

Relation	Date of birth

Do you have any close family in Australia (parent, wife/husband, child, brother/sister)? If YES, please provide further information such as their immigration status? How long have they been in Australia?*

No
Yes

Please provide further information such as their immigration status? How long have they been in Australia?

Relation	Immigration Status	How long in Australia

Do you have any close family in Australia (parent, wife/husband, child, brother/sister)? If YES, please provide further information such as their immigration status? How long have they been in Australia?

How do you intend to finance your study and living expenses for the entire duration of your stay in Australia?*

Other, specify:

Are you relying on working in Australia to cover your tuition and living fees?*

No
Yes

Please indicate the type of accommodation you intend to live in while studying at ?*

Please indicate the type of accommodation you intend to live in while studying at ?

Have you, or any dependants, been refused visa to Australia or any other country?*

Yes
No

Please list any current or previous immigration history. Have you, or any dependants, been refused visa to Australia or any other country?

Visa type	Granted / Refused	Month and year of grant

Have you been reported to DOHA for non-compliance? (This includes being reported for attendance and/or academic progress and/or nonpayment of fees, or being expelled?)*

No
Yes

Comments

Provide the best way for us to contact you to conduct an interview:*

Way of contact	Contact number, username...

Ex: Way of Contact may be Skype, Mobile phone, Viber, WhatsApp

Policies & Declaration

For information about our Fees and Refund policy, Enrolment policy, Complaints and Appeals policy, Attendance policy, Academic progress policy and any other policies please refer to www.cityinstitute.edu.au.

Payments

Payments can be made by:

Direct deposit
Electronic transfer
Cash
Cheque
Credit Card (Visa, Master attracts 2%, AMEX attracts 4% surcharge)

Account details

Bank:
Branch:
Account Name:
BSB :
Account Number:
SWIFT Code:

Who is filling out the application?*

Applicant's Declaration

I declare that the information supplied by me on this form is true and correct.
I declare that my application is genuine and by making this application I have every intention of completing all courses listed in the application.
I declare that all evidence provided with my application is authentic and valid.
I consent to obtaining information from educational institutions and relevant authorities concerning my entire study history including enrolment, academic results, attendance and finances.
I understand that information relating to my application may be provided to DOHA.
I have read and understood and accept admission requirements and above listed conditions.
I have read and understood the Transfer between registered providers policy.

Agent's Declaration

I undertake to provide support to the student in an honest, ethical and responsible manner, in accordance with the ESOS Act, the National Code and the Migration Act requirements
I have interviewed the student and believe that s/he is meeting the requirements of Genuine Temporary Entrant and is a Genuine Student as defined by DOHA and the student intends to comply with visa conditions and complete all the courses enrolled into to the best of their ability.
I have read and understood and accept admission requirements and above listed conditions.
I have read and understood the Transfer between registered providers’ policy.

Agent's name

Agent's signature

Please put write your signature into this field using mouse or touchpad.

Declaration & Submit

I understand and agree that:*

Applicant's Signature

Please put write your signature into this field using mouse or touchpad.

Date*

Application Checklist

Other, please specify:

File Uploads

Copy of your passport, visa, resume, certificates and other.

Drop files here or

Max. file size: 5 MB.

Maximum file upload size is 5MB

Copy of your resume attached

Yes
No

Cancellation and Refund policy

The Enrolment Fee, Accommodation Placement Fees and Airport Pick-Up Fees are non-refundable whether you complete your course or not. A $100 fee is payable for additional COEs (4th, 5th, etc.) or more than 3 instalment payments.
A $500 fee is payable for administering course cancellation after course commencement.
Where a student has cancelled prior to commencement a fee of $150 is charged for processing the refund (except in visa rejection cases).
An administrative charge of $100 is made to vary an application e.g. Change of Start Date, Change of Course etc.
If your application for a visa to study in Australia is rejected before the commencement date of the course and the College receives notification in writing and a copy of the Australian Embassy rejection letter a full refund of all pre-paid tuition fees, minus the lesser of $500 or 5% of the total pre-paid tuition fees will be paid. If you commence a course at the College and subsequently your visa application is rejected, a refund of the portion of tuition fees which you have paid but for which tuition has not yet been received will be paid. Proof of refusal letter must be provided no later than 4 weeks after refusal date, otherwise normal cancellation fees may be charged.
Tuition Fees and OSHC are refunded in full if your visa application is rejected and you provide official written notification of the refusal from the AustralianGovernment.
Student Default: No refund will be made if a student:
- has given false or misleading information
- fails to comply with the conditions of enrolment at the college
- is in breach of their visa requirements as imposed by the Australian Government
- withdraws after the commencement date of the course
Tuition fee refund: If you give written notice of your intention to withdraw from a course
- 40 days of more before the commencement date, tuition fees will be refunded less a cancellation fee of 15%.
- more than 5 days before the commencement date, tuition fees will be refunded less a cancellation fee of 30%.
- less than 5 days before course commencement date, tuition fees will be refunded less a cancellation fee of 45%.
  
  Refund procedures:
- You must complete the Refund Application Form, provide letter of refusal from the Australian government and the 3rd Party Form if the student wants the agent to receive the refund of tuition fees on his/her behalf.
- Your refund will be processed within 4 weeks of receipt of your completed refund application if it includes all the required documents. A written statement will be provided to the student to explain how the refund is calculated.
Where 2 or more courses are packaged, the conditions apply to all elements. Note that for packaged courses the course start date is taken to be the start date of the first course.
Commencement of the course is defined as the course start date in the first Application form submitted by the student or agent and not subsequent changes to the starting date.
Refunds from student cancellations will attract an administration charge of $150.00.
Course and other Fees are not transferable to another student or institution but may be transferred to another coursewithin the college at the discretion of the college.
Any approved refunds are made payable to and sent to the student or his/her agent, in the country of origin as applicable in Australian dollars.
Bank charges are deducted for refunds made by bank draft or electronic transfer.
If the refund is to be paid to a third party (i.e agent, friend or relative) a Student Authorisation Form must be completed and signed off stating the nominated person and banking details by the student listed in the International Student Application Form. Conflicting information will delay the refund process.
Provider Default: In the unlikely event that the college is unable to deliver your course in full starting from the agreed date, you will be offered a partial refund of unused tuition fees within 2 weeks after the default date. This would include course cancellation due to low enrolments.
Fees for services paid to education agents by students are not covered by this refund policy.
This refund policy applies to all tuition fees paid to the college and includes any tuition fees paid to an education agent to be remitted to the college.
All refund considerations will be strictly limited to the monies paid, which the college has received from the student as tuition fees only i.e. exclusive of all non-refundable fees and agents' commission (whether this commission was deducted before or after student payment to the college).
Students are encouraged to view the college student handbook as part of the enrolment, please refer to the college website www.astleycollege.com.au section "Study."
This agreement and the availability of complaints and appeals processes does not remove the right of the student to take action under Australia's Consumer Protection Laws available at http://consumerlaw.gov.au/

OSHC

OL OSHC

Elicos OL OSHC

OL Other fee

Elicos OL Other fee

Elicos OSHC

Material fee

Elicos Material fee

OL Material fee

Elicos OL Material fee

Enrollment fee

Elicos Enrollment fee

Offer Letter Enrollment fee

Elicos Offer Letter Enrollment fee

Material Fee Period

Elicos Material Fee Period

OL Material Fee Period

Elicos OL Material Fee Period

Course 1 Installments

Installment Number	Due date	Tuition Fee	Material Fee

Elicos Course 1 Installments

Installment Number	Due date	Tuition Fee	Material Fee

Course 2 Installments

Installment Number	Due date	Tuition Fee	Material Fee

Elicos Course 2 Installments

Installment Number	Due date	Tuition Fee	Material Fee

Elicos Course 3 Installments

Installment Number	Due date	Tuition Fee	Material Fee

Elicos Course 4 Installments

Installment Number	Due date	Tuition Fee	Material Fee

Elicos Course 5 Installments

Installment Number	Due date	Tuition Fee	Material Fee

Course 3 Installments

Installment Number	Due date	Tuition Fee	Material Fee

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Course 1 Prices

Session	Location	Fee	Period

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Course 2 Prices

Session	Location	Fee	Period

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Course 3 Prices

Session	Location	Fee	Period

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Course 4 Prices

Session	Location	Fee	Period

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Application Type

ENROLMENT FORM

Enrolment Form

Personal Details

Contact Details

Other

Your current Australian visa

Overseas Address

Address in Australia

Entry requirements

Language & Culture

English Proficiency

Culture

Agent's Details

Contact Information

Previous Education

Tertiary Education

Academic History

Employment

RPL & Credit Transfer

Disabilities

Course Selection

Select Your Courses

Other Courses

OSHC

How did you hear about us?

Statement of Purpose

Policies & Declaration

Payments

Applicant's Declaration

Agent's Declaration

Declaration & Submit

Application Checklist

File Uploads

705/107 Walker Street, North Sydney, 2060

+61 0426 049 029

[email protected]