Applicaon to study at JCU
Have you previously applied to or studied at JCU? No Yes - Student ID (if known):
Family Name: Title:
Given Names: Gender: Male Female Other
Have you been known by any other name/s (if so state here)?:
Date of Birth (dd/mm/yy): Email:
Permanent Home Address:
Mailing Address (if dierent from above):
Home Phone Number:
Mobile Phone Number:
Emergency Contact Name: Relaonship to you:
Emergency home phone number: Emergency work phone number:
If you are currently studying at JCU do you intend to connue your current course at the same me as this new
Yes No
Are you applying for cross instuonal study? Yes No
If yes, complete and aach the Home Instuon Approval for Cross Instuonal Study at JCU form
C o u r s e :
Brisbane Cairns Mount Isa Mackay Thursday Island Townsville External
Year Teaching Period 1 Teaching Period 2
Brisbane only: Trimester 1
(March) Trimester 2 (July) Trimester 3 (November)
Full me Part me
Commonwealth Supported Tuion Fee Paying
- We strongly recommend you contact Centrelink to check your eligibility
for entlements when spling study load across two courses or when
studying part me.
- Not all courses available at all campuses
- All domesc undergraduate degrees are Commonwealth Supported.
A number of Commonwealth Supported Places are available in SOME
domesc postgraduate coursework courses. Refer to hps://www.jcu. Please refer to
hps://nancial-support for more
informaon on student fees.
Individual Subjects:
Use this form if you are a domesc applicant, OR if you are applying
for Internaonal non-award subjects, OR if you are a non JCU student
applying for cross instuonal study.
Major (if applicable):
Proposed Supervisor:
(for Research Methods only)
Country of Cizenship: Country of Birth:
Do you hold a current Australian Visa?: Yes (If yes, please provide a copy) No
If you were born overseas, what was your rst year of arrival?:
Do you idenfy as Aboriginal, Torres Strait Islander, Aboriginal and Torres Strait Islander?:
Yes No Declining to answer
If yes, please select ONE only: Aboriginal Torres Strait Islander Aboriginal & Torres Strait Islander
Main language spoken at home:
Did you complete Year 12? No Yes If yes, what year did you complete Year 12?:
Provide details of any courses that you currently or have previously been enrolled in (including trade cercates,
cercates, terary preparatory courses and terary level courses).
Name/Level of Course
(eg. Cert III in Business)
Name of Instuon
Years aended
Did you complete
the course?
From To
Yes No
Yes No
Yes No
Yes No
Posion / Job Title Key Dues undertaken Duraon of Employment
This informaon is required by the Australian Government for stascal purposes.
It will not be used in the assessment of your applicaon.
Parent/Guardian 1
Male Female Other
Parent/Guardian 2
Male Female Other
What is the highest level of educaon completed by the per-
son/s who were your parents/guardians during school years:
Postgraduate Qualicaon
(e.g. Graduate diploma, Masters)
Bachelor degree
Other post-school qualicaon
(e.g. Advanced Diploma, VET/TAFE cercate, apprenceship)
Completed Year 12 schooling
Completed Year 10 schooling
Did not complete Year 10 schooling
Do not know
Where possible, include the following with your applicaon:
aAcademic transcripts
aAddional Supporng Documentaon (eg. resume, employment leer, referee report) – click here for more info
aMarriage Cercate/Deed Poll/Change of Name Cercate (if your name is dierent from that on your qualica-
ons and/or you have previously studied at JCU under a dierent name)
aAustralian Visa (if you are the holder of an Australian Visa)
aProof of cizenship (if you are an Australian cizen but were born overseas)
aEnhanced Study for Secondary School Students form if you intend to study at JCU while also compleng Year 11/12
aHome Instuon Approval for Cross Instuonal Study at JCU form - if you are applying for cross instuonal study
aApplicaon for Advanced Standing if you intend to apply for credit for previous studies
You will need to provide an ocial translaon for any documents in a language other than English.
You may be required to provide cered copies.
1. Qualicaon Search & Informaon Vericaon
1.1 I authorise James Cook University to obtain further informaon with respect to my applicaon and, if necessary, seek academic informaon or transcripts
from Australian or overseas educaonal instuons. Where necessary QualSearch will be engaged to access this academic informaon. I understand that
James Cook University is not responsible if any educaonal body / instuon does not supply these records. I understand that the results of the search
will be made available to me on request and that an audit of this authority may also be undertaken.
1.2 I authorise James Cook University to contact the referees named in my applicaon to seek addional informaon or claricaon. I acknowledge that
James Cook University may seek to verify any publicaons listed in which I am named as an author by contacng the publisher, editor or co-authors
and may seek to contact sta from the Educaonal Instuon where any research projects, theses or dissertaons referred to in this applicaon were
2. Informed Consent
2.1 I understand that:
a) James Cook University is collecng the informaon which I have provided in this form for the purpose of assessing my entlement to Commonwealth
assistance under the Higher Educaon Support Act 2003 or the Research Training Scheme and allocaon of a Commonwealth Higher Educaon
Student Support Number (CHESSN) to me
b) James Cook University will disclose the informaon I have provided in this form to the Department of Educaon and Training for those purposes
c) Department of Educaon and Training will store the informaon securely in the Higher Educaon Informaon Management System
d) Department of Educaon and Training may disclose the informaon to the Australian Taxaon Oce (ATO), and
James Cook University and Department of Educaon and Training will not otherwise disclose the informaon without my consent unless required or
authorised by law.
3. Privacy
3.1 James Cook University complies with the Informaon Privacy Act 2009. The informaon contained in this form is collected for admission and administra-
ve purposes. The informaon will be held by James Cook University and may be accessed and used by people employed the by the University. Personal
informaon will not be passed on to any other external bodies, other than as outlined above, without my authorisaon unless required or authorised
by law, or otherwise in accordance with the Informaon Privacy Principles. The provision of this informaon is voluntary, but if this informaon is not
provided, the University may be unable to process my applicaon or provide services to me. I have a right of access to, and correcon of my personal
informaon, subject to any excepons in relevant legislaon. I can direct any enquiries I may have in relaon to privacy to the University’s Privacy Ocer
(Deputy Director, Governance Support and Corporate Informaon, Governance and Corporate Services Oce, James Cook University, Townsville Qld
Applicant Signature: Date:
Email completed forms to:
Cairns, Townsville, Mackay, Mt Isa, Thursday Island campuses
Brisbane campus
Find out more
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