Fillable Application-Form-for-VET--TAFE--Programs-2018 Layout 1

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Application-Form-for-VET--TAFE--Programs-2018 Layout 1

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Application Form for
VET (TAFE) Programs
Warning – Uncontrolled when printed! The current version of this document is kept on the FedUni website.
A
u
th
o
r
ised by:
M
anager, Student HQ
Document Owner: University Registrar
Pa
g
e
1 of 2
Original Issue: 20/08/2014
Current Version: 09/01/2018
Review Date: 01/07/2018
CRICOS Provider Number 00103D | RTO 4909
2. Biographical (personal) details
Title
Mr Ms Mrs Miss Dr Other:
First name Your first legal given name
Other name
Your other legal name
Family name Your legal family name/ surname
Date of birth
/ /
D D M M Y Y Y Y
Gender
Male Female Other
Country of birth
Australia Other (please specify):
Notes:
1. Previous applications and/or enrolment
Including: University of Ballarat; Ballarat
University College; Ballarat College of
Advanced Education; School of Mines and
Industries, or Wimmera Institute of TAFE
Have you previously applied to, or been enrolled at, FedUni?
Yes No
If yes, please state FedUni Student ID number (if known)
Has your name changed since your last enrolment?
Yes No
If Yes, you must provide documentary
evidence (Marriage Certificate, Deed Poll or
Statutory Declaration) to support the change
If yes, previous name:
3. Home address
Please provide the physical address of
where you usually live – street number
and name not post office box. Do not
provide any temporary address at which
you reside for training, work or other
purposes before returning to your home.
If you are from a rural area use the
address from your state or territory’s ‘rural
property addressing’ or ‘numbering’
system as your residential street address.
Building/Property
Unit number Street number
Street name
Suburb/Town
State / Territory Post code
Telephone: Home
Preferred
Telephone: Work
Preferred
Please tick your preferred contact number.
Telephone: Mobile
Preferred
Please provide the email address you
c
heck most regularly.
Email
4. Mailing (postal) address
If different from your home address above
Building/Property
Unit number Street number
Street name
PO Box or Road Side Delivery (RSD) box number
Suburb/Town
State / Territory Post code
EMAIL info@federation.edu.au | CALL 1800 333 864 | WEB federation.edu.au
Program Informat
ion
www
.federation.edu.au/future-students or Student Recruitment at info@federation.edu.au or 1800 FED UNI.
Before completing this form, please check the application method, closing dates, entry requirements and
extra requirements for your preferred program. This information can all be found at:
study.federation.edu.au
Warning – Uncontrolled when printed! The current version of this document is kept on the FedUni website.
Authorised by:
M
anager, Student HQ
Document Owner: University Registrar
Page 2 of 2
CRICOS Provider Number 00103D | RTO 4909
Application form for VET (TAFE) programs, continued…
6. What is your citizenship status?
Australian Citizen New Zealand Citizen Overseas Resident
Permanent Humanitarian Visa Permanent Non-Humanitarian Visa Permanent Visa Holder
Please tick one box only
5. Are you of Aboriginal or Torres Strait Islander origin?
Notes:
No Yes, Aboriginal
Yes, Torres Strait Islander Yes, both Aboriginal and Torres Strait Islander
Please tick one box only
7. Post-secondary education
List all academic qualification/s previously attempted or completed
Year
started
Year
completed
Name of institution Name of qualification State
Successful
completion?
Yes No
Yes No
Yes No
Yes No
Oce Use Only
Application Centre:
FedUni (Direct application)
Admit Type: eg. DOM
Admit Term: eg.1401
National Program ID:
Data entry by
(please print name)
Please tick
School
Student HQ
Date
//
D D M M Y Y Y Y
Applicant ID
8. Program information
First preference, program name:
Year of
commencement
Y Y Y Y
Second preference, program name:
Privacy statement
The information being sought in this form is collected for the purpose of processing your application. The information will be held by the University and may be accessed
and used by people employed or engaged by the University in the delivery of services to you. The information may be used or disclosed to organisations outside the
University where permitted by relevant Privacy Legislation. The provisions of the information is voluntary, but if this information is not provided, the University may be
unable to process your enrolment. You have a right of access to, and correction of, your personal information in accordance with Privacy Legislation and the University’s
Information Privacy Policy. Please direct any enquires you may have in relation to this matter to the University’s Privacy Officer, telephone (03 5327 9021).
Applicant’s declaration
I declare that all information submitted is correct and complete.
I acknowledge that the provision of incorrect information may result in the withdrawal by the University of any place that may be offered.
Applicant’s
Signature
Date
//
D D M M Y Y Y Y
Students with a disability or chronic medical condition
The University provides a range of support services for
students with a disability or chronic medical condition.
Early contact will help enable the University to organize
appropriate services prior to the commencement of your
program. For information and/or support please contact the
Student Support Reception on: 03 5327 9470.
Admission for Australian Aboriginal and Torres Strait Islander people
Federation University Australia has a genuine commitment to Aboriginal and Torres Strait Islander issues
as evidenced by its Statement on Reconciliation, Indigenous Employment Strategy and Aboriginal
Education Centre that provides educational, cultural and personal support to Aboriginal and Torres Strait
Islander students. Aboriginal and Torres Strait Islander people who are unable to meet admission
requirements are able to seek consideration of their personal circumstances. Applications are considered
on an individual basis which may involve an interview. For more information about admissions and/or
support on a range of issues please contact the Aboriginal Education Centre on 03 5327 9795.
Please return this completed application form by mail or email
to the following addresses. Alternatively, deliver it in person
to Student HQ, SMB Campus or Horsham Campus.
Student HQ, SMB Campus
E
mail: info@federation.edu.au
Post:
Student HQ,
SMB Campus
Federation University
Australia
PO Box 668 BALLARAT
VIC 3353
Telephone: 1800 333 864
Student HQ, Horsham Campus
Email: info@federation.edu.au
Post: Student HQ, Horsham Campus
Federation University
Australia
PO Box 300 HORSHAM VIC 3402
Telephone: 1800 333 864
Original Issue: 20/08/2014
Current Version: 09/01/2018
Review Date: 01/07/2018
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