Fillable Professional Year Program Application Form (Australian Correspondence Schools)

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Professional Year Program Application Form (Australian Correspondence Schools)

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The Professional Year Program Application Form (Australian Correspondence Schools) form is 2 pages long and contains:

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Country of origin: AUSTRALIA
File type: PDF

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Professional Year Program Application Form
ICT – 2021
Personal Details
Title Mr Mrs Ms Miss Other
Family Name:
Given Names:
Date of Birth:
Gender Male Female
Do you have a disability? Yes No
If yes please specify:
Student’s Contact Details
Postcode:
Telephone:
Address :
Suburb :
State :
Email :
Agents Name (if any):
Passport/Visa Details
Country of Birth
Country of Citizenship
Passport Number
Do you hold a 485 Visa?
Yes
No
If Yes, Expiry Date
If No, have you applied?
Yes
No
I hold another Visa
Visa Type
Australian Education Details
Date Completed
Course Name
Institute
English Proficiency
Test
IELTS
PTE
TOEFL
Date of Test
Overall Score
Component Score
Writing
Reading
Speaking
Listening
ICT APPLICANTS REQUIRE AN ELT SCORE WITH NO BAND BELOW 6 (IELTS or EQUIVALENT)
QIBA Pty Ltd | CRICOS Provider Code: 01515J | RTO Code: 5304 | ABN: 35 071 667 108
Level 2 108 Margaret Street BRISBANE QLD AUSTRALIA 4000 t: 07 3186 6449
Level 10 140 Elizabeth Street SYDNEY NSW AUSTRALIA 2000 t: 02 9267 3040
info@qiba.edu.au www.qiba.edu.au
Professional Year (ICT) Application Form V3.2
QIBA Pty Ltd | CRICOS Provider Code: 01515J | RTO Code: 5304 | ABN: 35 071 667 108
Level 2 108 Margaret Street BRISBANE QLD AUSTRALIA 4000 t: 07 3186 6449
Level 10 140 Elizabeth Street SYDNEY NSW AUSTRALIA 2000 t: 02 9267 3040
info@qiba.edu.au www.qiba.edu.au
Program Location Preference
Sydney (CBD) Canberra Hobart Darwin
Brisbane
Preferred Intake Date
Skilled Graduate 485 Visa
English Proficiency Results
Supporting Certified Documents
ICT Applicants
Passport Skilled Graduate 485 Visa English Proficiency Results
Academic Transcript Course Completion Letter
Payment Options
ICT
Upfront payment Instalment payment (6 instalments)
Declaration
I declare that the information supplied by me on this form is true and correct.
I acknowledge that QIBA reserves the right to vary or reverse any decision regarding admission made on the basis of incorrect
or incomplete information.
I have read and understand the QIBA terms and conditions as explained in following link
https://www.qiba.edu.au/wp-content/uploads/2020/12/PYP-Terms-and-Conditions-V9.2.pdf and am fully aware of the
following:
QIBA will make no refund of tuition fees once the course begins.
Students using the instalment option for payment of tuition fees that choose to withdraw from the course after
it has begun are liable for full tuition fees. Finalisation of the account must be by the date stipulated on the agreed
instalment plan. Failure to do so will result in legal action and outstanding fees will be referred to an external
collection agency as outlined in the terms and conditions.
I understand that I must complete a face-to-face Pre-Enrolment interview, plus an online Orientation, prior to
being eligible to commence on the scheduled start date.
I understand that completion of the Professional Year Program does not guarantee permanent residency in Australia and
such decisions are at the discretion of the DHA alone.
I DECLARE I HAVE READ THE ABOVE TERMS AND CONDITIONS AND COMPLETELY UNDERSTAND MY OBLIGATIONS
Full Name:
Date :
Submitted By:
Self
Agent:
Agent phone:
QIBA – Professional Year Program
Payment Options
Payment Options
t 02 9052 8824
t 02 9267 3040
e marketing@qiba.edu.au
e py.enrolments@qiba.edu.au
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Professional Year Program Application Form (Australian Correspondence Schools)

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Completed 12 July 2021

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