USQ Application Form
USQ Application Form
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Note: If you apply through an approved USQ Representative, all correspondence will be forwarded through the representative office.
Do you have a disability, impairment or long term medical condition which may affect your studies?
Yes
No
1. lc:seacl uctcils (Please PRINT capital letters)
Preferred Title (Mr / Mrs / Ms / Miss / Dr) __________ Family Name (as per Passport) ________________________________________________________________________
Given Name/s ________________________________________________________ Preferred Name _______________________________________________________
Date of Birth (dd/mm/yy) ______/______/______ Gender
Male
Toowoomba
Fraser Coast
Springfield
Other ________________
Distance
Direct
Yes
No
Further Studies after High School /Year 12
Yes
No
If you answered YES to the either of the above questions, please attach
certified evidence from the institution confirming the language of instruction.
If you answered NO to both of the above questions, you need to supply certified evidence
of your English Language Proficiency:
Yes
No
(It is usual that applications for exemptions/credits are only considered once you have provided official subject outlines, descriptions and results for the course you are wishing to seek
credit. Applicants from pre-approved programs will be granted appropriate exemptions/credit on submission of certified results.)
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Recommended by friend/relative
Exhibition/Seminar
Internet
Newspaper
Magazine
Other _______________________________
(please specify)
. !c:ms cac teacitieas Please read the following terms and conditions and then sign this form.
I declare that the information supplied by me in this form and relevant attachments is true and correct. I understand that the University may vary or terminate its offer of a place at USQ or any subsequent
agreement regarding study at USQ if any of the information provided by me is shown to be incorrect. I have read and accept the Universitys fees, charges and refund policy (http://www.usq.edu.au/
international). I understand that there are limited places available and that early submission of this application will give me a better chance of obtaining a place in the program of my choice. I am aware
of the applicable tuition fees and understand that I do not have to pay until I return the Acceptance of Offer Form included in the letter of offer from the University.
USQ collects personal information to assist the University in providing tertiary education and related ancillary services and to be able to contact you regarding enrolment, assessment and associated
USQ services. The information may be made available to Commonwealth and State agencies and the ESOS Assurance Fund Manager pursuant to obligations under the Education Services for Overseas
Students Act 2000 and National Code or other legislative requirements. Personal information will not be disclosed to third parties other than a USQ approved agent, partner or any organisation who
provides sponsorship to you for your studies, without your consent unless required by law.
Signature ___________________________________________________________________________ Date ______/______/_______
Lodging your Application
To ensure your application is processed without delay, please attach certified photocopies of academic transcripts and certificates (i.e. signed
by a teacher, lawyer, your local USQ representative or other person in authority). If your documents are not in English, please attach certified
English translated versions of your documents. Do not send original documents. Failure to include attachments may delay the processing of
your application. Please note: USQ does not charge an application fee.
Lodge this application with your local USQ Agent or USQ Education Partner or, if none, mail/fax direct to USQ International Admissions.
USQ International Admissions
University of Southern Queensland
Toowoomba | QLD | 4350 | Australia
Phone: +61 7 4631 2362
Fax: +61 7 4635 9225
Email: ioadmissionsusq.edu.au
web: www.usq.edu.au/international
University of Southern Queensland is a registered
provider of education with the Australian Government USQ Graphics (07-214b) 08/07
. tmle,mcat tzc:icacc (if applicable)
Please only supply this information if it is a prerequisite for your program in which case you must attach your Curriculum Vitae (CV)/Resume with letters of reference or other
documentary evidence of your work experience.
Start
Date
Finish
Date
Full-time or
Part-time
Occupation Title
Main tasks or duties
usually performed by you
Name of Employer
CRICOS QLD 00244B NSW 02225M