INTERCAMPUS MOBILITY APPLICATION
INTERCAMPUS MOBILITY
APPLICATION
INFORMATION
This for is ONLY for use by students applying to participate in JCU’s Intercampus Mobility program. Applicants for this program must be currently
admitted to a course at JCU Townsville, Cairns or Singapore. The Intercampus Mobility program facilitates temporary study at another JCU campus
while the student remains admitted to their current course of study at their home campus. Students engaging this program must return to study at
their home campus after the period of mobility conculdes. Students intending to permanently transfer to another JCU campus should apply using JCU’s
Campus Transfer application form.
Applicants must at least satisfy the following minimum criteria before submitting their application:
Submit your application at least 15 weeks prior to the start date of the study period you intend to commence Mobility at the destination campus
Completed at least 12 credit points in your course at your home campus
Have an Academic Standing of “Good Standing”
Must not have any outstanding debt or owe fees at any JCU campus.
1. TRANSFER DETAILS
I am a student at the: Applying to temporarily study via JCUs Mobility program at the:
r Townsville Campus r Townsville Campus
r Cairns Campus r Cairns Campus
r Singapore Campus r Singapore Campus
2. PERSONAL DETAILS
Student Number:
Title: rMr rMrs rMs rMiss rOther __________
Given names: Family name:
r Male r Female
Date of birth (dd/mm/yyyy): / /
JCU email address:
Alternate email address:
Home phone number: Mobile phone number:
Emergency contact/parent details:
Emergency contact phone number:
3. CITIZEN AND RESIDENCY STATUS
What is your citizenship or residence status? Please choose one option only.
r Australian Citizen r New Zealand citizen
r Holder of a permanent non-humanitarian visa r Holder of a permanent humanitarian residence visa (evidence required)
r International student r Other______________________________________
Country of passport: Passport number: Expiry date:
4. CURRENT COURSE INFORMATION AND TIMING OF MOBILITY
Current course: Course code:
Course title:
Major 1: _____________________________________________
Major 2: _____________________________________________
There are specic openings between trimester and semesters when the mobility program is available. Indicate your intentions below:
JCUS to JCUA JCUA to JCUS
Start at JCUA Duration Start at JCUS Duration
r TP2 (recommended) r 1 semester r SP 51 (recommended) r 1 trimester
r TP1 r 2 semesters r SP 52 r 2 trimesters
r Other (to be negotiated with assessor) r Other (to be negotiated with assessor)
What year/s are you applying to go on Intercampus Mobility?
Year/s: ___________________
What year/s are you applying to go on Intercampus Mobility?
Year/s: ___________________
Date received: / /
INTERCAMPUS MOBILITY APPLICATION
5. IMPORTANT INFORMATION
Your application CANNOT be considered if you have an outstanding debt or Statement of Reasons at your current campus.
6. DECLARATION - SINGAPORE STUDENTS
I make this declaration in relation to my application for my preferred course/s at James Cook University (JCU). I understand that the University
will rely on this declaration in relation to any oer of enrolment in the Course which is made to me.
I declare that:
I am a Genuine Temporary Entrant*;
Studying the Course is my primary purpose for coming to Australia;
I understand that if I am granted an Australian student visa, I will have to comply with the conditions on that visa;
I believe that I am academically qualied for the Course I have applied for and have, or will have, the English prociency level required to
commence the Course;
I have calculated the cost of my course, am aware of the current exchange rate between the currency of my home country and the
Australian dollar and understand that the exchange rate will vary from time to time;
I have genuine access to the total funds required**, while in Australia, to cover all tuition fees, travel (including return airfare), living costs
and Overseas Student Health Cover for myself and my dependents (if any) for the duration of the Course; and
If I have ever been refused a visa for entry into Australia, I have advised JCU and provided a copy of the visa refusal notication from
Australian Government and any other relevant documentation
If I have ever been refused a visa for entry into another country, I have advised JCU of the country and provided relevant documentation.
* For the denition of Genuine Temporary Entrant under the Simplied Student Visa Framework (SSVF) visit: the Department of Home Aairs
(DoHA) Genuine Temporary Entrant (GTE) requirements: www.homeaairs.gov.au/Trav/Stud/More/Genuine-Temporary-Entrant
**For nancial requirements for obtaining a student visa under the SSVF visit: the Department of Home Aairs (DoHA) Student visa nancial
capacity requirements: www.homeaairs.gov.au/Trav/Stud/More/Student-Visa-Living-Costs-and-Evidence-of-Funds
PRIVACY
Personal information supplied on this form will be handled in accordance with JCU’s Privacy Policy (available at jcu.edu.au).
I acknowledge that James Cook University (JCU) will use the personal information that I have provided in, and attached to, this form to assess
my application to study at JCU. I authorise JCU to provide my personal information to the Australia Government Department that is responsible
for tertiary education (including the Department of Education and Training), the Australian Government Department that manages immigration
(including the Department of Home Aairs), the Tuition Protection Service, my Education Agent if I have appointed one, Allianz Global Assistance
if I nominated JCU to arrange my Overseas Student Health Cover (OSHC) and any other Australian or Queensland Government bodies as required
by law.
Signature: __________________________________________ Date (dd/mm/yyyy): _________/_________/_______________
7. ALL STUDENTS TO SIGN
Signature: __________________________________________ Date (dd/mm/yyyy): _________/_________/_______________
8. RETURN FORM
Townsville
Postal: James Cook University
Student Centre
Education Central (Bld. 134)
Townsville, 4811
In person: Student Centre
Education Central (Bld. 134)
James Cook Drive
Townsville
Cairns
Postal: James Cook University
Student Centre
Chancellery Building (Bld. A1)
Cairns, 4870
In person: Student Centre
Chancellery Building (Bld. A1)
McGregor Road
Smitheld
Singapore
James Cook University
149 Sims Drive
Student Services, Block C
Singapore 387380
Tel: +65 6709 3688
Email: studentservices-singapore@jcu.edu.au
Please return your form to the campus that you are currently studying at. Your home campus will process and forward it to the appropriate area at
your proposed destination campus.
click to sign
signature
click to edit
click to sign
signature
click to edit
INTERCAMPUS MOBILITY APPLICATION
OFFICE USE - ACADEMIC ASSESSOR AT HOME CAMPUS
Mobility enrolment information: Sanctions:
Are there suitable subjects available that meet the requirements of
the student’s course at the destination campus?
rYes r No
If no, is there an alternative? ________________________________
________________________________________________________
List the subjects and study period(s) the student may enrol in at the
destination campus while on Intercampus mobility? ____________
________________________________________________________
________________________________________________________
Does the student have a debtor sanction? rYes r No
If yes, sanction details: _______________________________
__________________________________________________
What is the student’s academic status?
______________________________________________
If required, has a Statement of Reasons been received?
rYes r No
Has it been approved: rYes r No
________________________________________________________
________________________________________________________
Current enrolment:
Are there any current enrolled subjects with outstanding grades?
rNo r Yes Please list them: ____________________________________________________________________________
Comments: __________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
r Mobility approved r Not approved: ___________________________________________________________
__________________________________ _______________________________________ ________/________/__________
Signature Print name Date (dd/mm/yyyy)
PROPOSED STUDY PLAN FOR DESTINATION CAMPUS:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Student signature: __________________________________________ Date (dd/mm/yyyy): _________/_________/__________
click to sign
signature
click to edit
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome