APPLICATION FORM

Please print clearly in English and in BLOCK letters. Tick boxes where appropriate.
International Student Application Domestic Student Application
Representative information
Representative name (if relevant)

City Telephone (home/mobile)

Email

Representative signature

Student information (compulsory)

Title   Mr   Ms  Other Gender  M  F  Unspecified
Family name First name(s)

Date of birth (d/m/y) Country of birth

Country of citizenship First language

Permanent address*

City State/province Postcode

Country Telephone (home/mobile)

Are you an Australian Aboriginal or Torres Strait Islander?   Yes  No

The University of Adelaide/The University of Adelaide College – Student ID and Online Account Activation
Student ID card, ID number and system password will only be granted to a valid personal student email address. Enrolment and system access delays will occur if invalid email addresses are provided.

Email

Passport number (if available) Expiry date

Do you hold Permanent Residency or a current Australian Visa?

 Yes  No   N/A If yes, please provide a copy of your PR or current Australian visa.
Visa type (if relevant) Visa number (if relevant)

*Your permanent/home country address is required by the Australian Government. If it is not supplied your application cannot be processed

Parent / legal guardian details (compulsory for students under 18)

Title   Mr   Ms  Other Gender  M  F  Unspecified
Family name First name(s)

Relationship to student (i.e. mother or father)

Permanent address of Parent or Guardian

Email

Telephone (home/mobile)

Education history
If you are currently completing a qualification, please indicate when you expect to complete this study (month/year).

Name and location of institution (starting from the most recent qualification)

Qualification/Award received Years attended (e.g. 2016-2018)

Name and location of institution

Qualification/Award received Years attended (e.g. 2014-2016)

college.adelaide.edu.au Foundation Studies, Degree Transfer and Pre-Master’s programs

(The University of Adelaide) CRICOS 00123M | English language programs
(Kaplan) CRICOS 03127E.
 APPLICATION FORM

Current English proficiency

Is English your first language?   Yes  No
Have you studied at secondary level with English as the language of instruction?
 Yes   No If yes, please provide evidence of language of instruction.
Do you have an English Language score? If yes, please select one of the following Test date (d/m/y) Score
 Yes  No  IELTS  TOEFL   iBT TOEFL
  Pearson Test of English  Other

Program selection
Degree Transfer Foundation Studies Pre-Master’s General Academic English
  Degree Transfer Extended (Mar)   Foundation Studies (Feb)   Pre-Master's – Two semesters (Mar)   General Academic English
  Degree Transfer Extended (Oct)   Foundation Studies (Jul)   Pre-Master's – Two semesters (Oct)
  Degree Transfer Standard (Feb)  Foundation Studies Accelerated (Oct)   Pre-Master’s – One semester (Feb)
  Degree Transfer Standard (Jul)   Pre-Master’s – One semester (Jul)
 Degree Transfer Accelerated (Oct)   Pre-Master’s - Two trimesters (Oct)
  Pre-Master’s - One trimester (Feb)
Year of entry to the University of Adelaide College: (e.g. 2017, 2018)

University Program
Please indicate which Bachelor or Master degree you intend to study at the University of Adelaide (e.g. Bachelor of Engineering [Civil])
Bachelor/Master of:                                        

Accommodation
Would you like the College to organise your accommodation for you in Adelaide?   Yes  No
If yes, please complete the accommodation application form. The form includes all the accommodation options.
Would you like the College to organise your airport pick-up?   Yes  No

Additional services
Would you like the University of Adelaide College to organise your Overseas Student Health Cover (OSHC) on your behalf?   Yes  No

If yes, please indicate:   Single   Couples  Family If no, please list your current OSHC details
Policy provider:

Policy number: Start date: Expiry date:

*Please note that OSHC is mandatory for Student Visa holders and their accompanying family members.

Medical conditions
Do you have a disability, impairment or long-term medical condition which may affect your studies?   Yes  No
If yes, please provide medical documentation from a relevant treating professional detailing the impact of your condition on your ability to meet academic demands.
Disclosure will not disadvantage your application and is confidential. The information you provide will assist us in best catering for your needs.

Privacy notice
The University of Adelaide College understands and respects that privacy is important to you. We collect personal information about you so that we can provide you with the services you have
requested. We may also use your information to improve our products and services and offer you our, or our partners’ or suppliers’, products and services which may be relevant to you. We may
disclose personal information about you in accordance with our Privacy Policy (available at www.college.adelaide.edu.au), including to your education agent and the Australian government. Our
privacy policy contains information about how you can access and correct the personal information we hold about you, or make a privacy complaint. You may contact the Privacy Officer (privacy@
kaplan.edu.au) for more information.
In regard to promotional material, please indicate below.
 I do not want to receive communication in any format from the University of Adelaide College sent on behalf of its sponsors, partners or suppliers, or
 I do not want to receive communication in any format from the University of Adelaide College about its own publications, information and events.

Declaration
I have read, understood and agree to be bound by the Terms and Conditions of enrolment. I declare that I have read the instructions on this application form and that, to the best of my knowledge,
the information provided by me is true and complete in every particular. I acknowledge that the University of Adelaide College and the University of Adelaide may vary or reverse any decision
regarding admission or enrolment made on the basis of incorrect or incomplete information provided by me. I give permission to the University of Adelaide College to verify or obtain records from
other educational institutions that I have attended. I understand that I am seeking temporary entry into Australia for educational purposes only as a fee-paying student. I understand that if I change
my visa status, I may be subject to different rules and conditions. I understand the above conditions and am prepared to accept them in full. In particular that I, or my sponsor, will be responsible for
the full costs of the academic program for which I am seeking admission, as well as the associated travel and living costs. I give permission to the University of Adelaide College to provide informa-
tion to my parent(s) or guardian(s) and my agent regarding my application for admission to the program listed above.
  I confirm that I have read, understood and agree to be bound by the University of Adelaide College Terms and Conditions (refer to page 43).
Signature of student Date

Signature of parent/guardian (required if student is under 18 years old) Date

college.adelaide.edu.au Foundation Studies, Degree Transfer and Pre-Master’s programs

(The University of Adelaide) CRICOS 00123M | English language programs
(Kaplan) CRICOS 03127E.
TERMS AND CONDITIONS
1. GENERAL TERMS AND CONDITIONS • The student withdraws after commencing their course. In this case, the student is liable to pay the full tuition fee of the
These Terms and Conditions are applicable to all students studying at the University of Adelaide College through semester and any expenses, costs or disbursements incurred in recovering the tuition fee;
Kaplan Higher Education Pty Ltd ABN 85 124 217 670 CRICOS 03127E (the ’College’) including English Language • These Terms and Conditions, including an applicable requirement of a College policy, are breached by the student; or
Programs delivered by the College (CRICOS 03147E) and Foundation Studies, Degree Transfer and Pre-Master’s
programs delivered under agreement with the University of Adelaide (CRICOS 00123M). • The student’s enrolment is cancelled by the College.
1.1. Policies and procedures: All College students are subject to the policies and procedures that are published on our If the College has to cancel an international student’s enrolment caused by a serious breach of student visa conditions
website (www.college.adelaide.edu.au/policies/) and in the College student handbook, including those dealing with or serious misconduct, no refund of course fees will apply.
student misconduct, assessment, progression, enrolment deferral, and cancellation, complaints and appeals, and refund. 4.6. Protection of student fees: In the unlikely event that the College is unable to deliver a course in full, students will
Students must review these policies and procedures and ensure they understand and comply with the most up to date be offered a refund of all unspent tuition fees.This refund will be paid within 14 days of the day on which the course
version of our policies and procedures at all times. ceased being provided. Alternatively, students may be offered enrolment in an alternative course at no extra cost.
1.2. Late arrivals, vacations and absences: All students are expected to attend class from the first day of their course. No Students have the right to choose whether they would prefer a refund of unspent tuition fees or to accept a place in
refund is given for time missed due to arrivals after the published course commencement date, vacations, absences or another course. If they choose placement in another course, students will need to sign documentation to indicate their
public holidays. Such periods of absence will not be replaced by a free extension of any course. No refunds or substitutions acceptance of the placement. In the unlikely event that the College is unable to provide a refund or place a student in an
will be made for classes missed due to exams, excursions, first day orientation or other obligations that fall outside the alternative course, the Tuition Protection Service (TPS) will assist the student in finding an alternative course or to get
normal teaching schedule. Classes are not held, and many campus facilities are closed, on public holidays. All published a refund if a suitable alternative is not found. Further information concerning the TPS can be found at www.tps.gov.au.
course dates start on a Monday, but if the Monday is a public holiday, the course start will fall on the Tuesday. Students 4.7. Students that cancel their enrolment may not be eligible to receive a certificate for a partially completed course
may request written permission for late arrival up to 2 weeks from their published course commencement date. from the College.
1.3. Campus facilities: Students are advised that campus facilities may not be available during study breaks. Details are 5. INTERNATIONAL STUDENTS
available from the Student Services Team or Reception staff at the College. 5.1.Visa information: It is the responsibility of the student to arrange all applicable travel permits or visas and to have
1.4. Placement:The College may place a student into the most appropriate class and postpone subjects to the following a valid passport for their whole period of study.The student may be asked to make payment for their first study period
semester where there is an insufficient number of students for that class or subject. before any of their visa documentation is issued.Visa application forms (Confirmation of Enrolment) may not be
issued by the College until payment for the first study period has been received and the Offer of Admission agreement
1.5. Program changes:The College may change course dates, course curricula, tutors and programs at any time at its has been signed and returned to the College by the student.The pre-arrival information and grievance procedures can
discretion. However, in cases where the course is rescheduled before the first class and the new date is unacceptable to be found on our website www.college.adelaide.edu.au.
the student all unused tuition fees will be refunded.
5.2. Student visa obligations: Student visa holders are required to maintain compliance with all applicable visa conditions
1.6.Tuition fees:The student or student’s family agrees to pay the total tuition fee and any additional charges in including providing the College with a current residential address, mobile number, email address and who to contact
accordance with the fee schedule for the current year published on our website www.college.adelaide.edu.au. Any in emergency situations, as well as notifying the College of any change in these details within 7 days of the change,
refund is made in accordance with the College Refund Policy.Tuition fees include lessons, orientation, placement and maintaining satisfactory academic progress and attending a minimum of 80% of their course. Students that fail to
progress testing and a College certificate upon successful completion of the course.The College may withhold the commence their enrolled course or fail to meet the requirement for 80% attendance or satisfactory academic progress
granting of a certificate from a student if the student’s tuition fees or any other fees remain outstanding. will be reported to the Department of Home Affairs. Any school-aged dependents accompanying overseas students to
1.7. Repeat payment: Students who need to repeat a subject or subjects or semester will be charged based on the Australia will be required to pay full fees if they are enrolled in either a government or non-government school.
current year’s published tuition fees at the time of payment. 5.3. Health insurance: Health insurance is compulsory for student visa holders and their accompanying family
1.8. Late payment: A fee of AUD 100 applies on unpaid accounts 30 days after the date the payment was due. members. Students are required to provide proof of health insurance at the time of their enrolment. Students will not
1.9. Books and learning materials: Students may be required to purchase textbooks, workbooks, stationery, software receive a Confirmation of Enrolment (CoE) until they have obtained satisfactory health insurance for the length of
and other required learning materials at an additional cost. Details of any additional costs are in the College student their visa.The Australian government requires all students on student visas to join the Overseas Student Health Cover
handbook or the relevant course or unit outline. (OSHC) scheme, a health insurance plan for overseas students in Australia. Students must ensure that payment is
made for compulsory OSHC before their visa is issued and that the insurance provides adequate coverage for the
1.10. Additional services: Any additional services (such as travel, telephone costs, excursions, medical costs, special duration of the student’s visa.
diet, non-College exams and enrolment amendments) are not included in any fees unless specifically stated on a valid
invoice from the College or ‘Offer of Admission. Students wishing to arrange homestay accommodation and/or airport 5.4. Codes of practice:The College abides by the National Code of Practice for Registration Authorities and Providers
transfer can obtain further information at www.college.adelaide.edu.au/accommodation/. of Education and Training to Overseas Students 2018 (the National Code) and the Educational Services for Overseas
Students Act 2000 (Cth) (ESOS Act). Further information about the National Code can be obtained at
1.11. Privacy: Personal information collected by the College or the University of Adelaide, which includes information
that identifies a student and information regarding a student’s course progress and attendance, may be shared by or internationaleducation.gov.au/regulatory-information/.
between the College and the University of Adelaide and by either or them with the Australian government, or State and 5.5. Living expenses: Migration regulations in Australia require international students to show evidence that they can
Territory governments, and their designated authorities, the Tuition Protection Scheme, the agent that recruited the contribute to the cost of living and studying in Australia. Further information can be obtained at www.studyinaustralia.
student (unless specifically excluded), the students’ parents (if under 18), College staff and contractors, and between gov.au/english/australian-education/education-costs, http://www.studyinaustralia.gov.au/english/live-in-australia/
the College and the University of Adelaide and related body corporates of the College and their staff and contractors. living-costs and www.homeaffairs.gov.au/.
This information may include personal information about you which is considered sensitive information, contact 6. CONSUMER PROTECTION
details, course enrolment details and changes, course results, and the circumstance of any suspected breach by the 6.1.This agreement, and the right to make complaints and seek appeals of decisions and actions under various
student of a visa condition.The College’s Privacy Policy outlines further information about the handling of personal processes, does not affect the rights of the student to take action under the Australian Consumer Law if the Australian
information by the College (at www.college.adelaide.edu.au/privacy/).You may contact our Privacy Officer at privacy@ Consumer Law applies.
kaplan.edu.au if you have any enquiries about your personal information or if you wish to make a privacy complaint.
6.2. Students will be advised of any changes to these Terms and Conditions that may result from a directive of the
1.12. Medical costs:The College is hereby authorised to seek medical treatment should the College or a staff member governing body of the College or the University of Adelaide, or from a change in government legislation or regulation.
acting on its behalf consider such action necessary for a student.The student agrees to indemnify the College for Any dispute, claim or other matter arising will be subject to the laws of South Australia.
any expense, loss, damage or liability whatsoever suffered or incurred as a result of authorising and arranging such
emergency medical treatment. 6.3. Students who are dissatisfied with a decision made by the College may submit a complaint to the College in
accordance with the relevant College Grievance Policy (available at www.college.adelaide.edu.au/policies). If a
1.13. Photography, filming and sound recording:The College or its representatives may arrange to photograph or shoot student is dissatisfied with the outcome of a complaint and subsequent appeal, they may also submit an application for
video footage of students for promotional or marketing purposes, in print and/or online, at any time. Any student who review of the College’s decision or action to the Overseas Student Ombudsman (if they are an international student) or
does not wish to participate should advise the College staff or its representative at the time of booking and state at the time to a State/Territory fair trading or consumer protection agency.
of the photographing or video shooting that they do not wish to participate.
7. DECLARATION
2.THE UNIVERSITY OF ADELAIDE FEES Upon submitting an application to the College, and subsequently undertaking any study at the College, the student (or
2.1.The University of Adelaide course fees will depend on the student’s choice of degree course and point of entry. their authorised representative on the student’s behalf – if the student is under 18 years of age):
Further information is available on the University of Adelaide website: www.adelaide.edu.au.
7.1. Declares that the information provided in their application form is true and complete in every detail.
3. DEFERRAL, SUSPENSION AND CANCELLATION OF ENROLMENT
3.1. A student may apply to defer their studies on the grounds of compelling or compassionate circumstances such 7.2. Understands that giving false or incomplete information may lead to the refusal of their application or cancellation
as their own ill health or that of a very close relative. All applications for deferral from a course of study must be made of their enrolment.
in writing or using the relevant form available from the College. Students should refer to the College’s Deferral, 7.3. Has read and understood the published information in the College brochure and on the College (and the
Suspension and Cancellation of Enrollment Policy (available at www.college.adelaide.edu.au/policies) for details of the University of Adelaide) website and has sufficient information about the College to enrol.
circumstances in which their enrolment may be deferred, suspended or cancelled, before submitting their application. 7.4. Authorises the College to retain their photo image for identification purposes and consents to the use of any
An administration fee of AUD 250 is required for processing a deferral application. photographs or video footage taken of the student for promotional or marketing purposes, without further consent or
3.2. A student’s enrolment at the College may be suspended or cancelled in accordance with the College’s Deferral, notification.
Suspension and Cancellation of Enrollment Policy (available at www.college.adelaide.edu.au/policies), including on the 7.5. Authorises the College to provide the University of Adelaide, or any other educational institutions to which the
grounds of misbehavior by the student, the student’s failure to pay amount(s) owing to the College in accordance with the student is seeking admission, any required relevant official records and other personal information relevant to their
Offer of Admission or a breach of course attendance and progression by the student. application or studies.The student also gives the College permission to obtain official records from any educational
4. REFUNDS institution the student has attended and from the University of Adelaide once their studies at the College have finished.
4.1.The College’s Refund Policy is available at www.college.adelaide.edu.au/policies. All students must read the 7.6. For international students, the student understands that the College will collect information during their enrolment
Refund Policy before accepting an offer of admission from the College. For the purposes of the refund policy only, in order to meet its obligations under the ESOS Act and the National Code and to ensure the student complies with
a course is defined as one semester of study, or for English programs a maximum of 25 weeks of study. Students the conditions of their visa and the student’s obligations under Australian immigration laws.The authority to collect
requesting a refund are required to do so in accordance with the Refund Policy. Approved refunds are paid in information is contained in the ESOS Act, ESOS Regulations and the National Code.The international student
Australian dollars into the bank account nominated on the refund form (the refund form is available by emailing authorises the College to provide information including personal and contact details, course enrolment details, and
college@adelaide.edu.au). All refund requests will be responded to in writing and approved refunds will be paid within 14 the circumstances of any suspected breach of their student visa conditions to the Australian Government, the Tuition
days of written notification by the College. For under 18 students, refunds will be paid to the parent(s) or guardian(s) Protection Service (if relevant) and any other designated authorities.The student also understands that this information
of the student unless the College receives written approval from a parent or guardian consenting for the refund to be can be disclosed without their consent where the College is authorised to or required to by law.
paid directly to the student.Tuition fees are not transferable to other students.
7.7. Understands and consent to the collection and handling of personal information in accordance with the College’s
4.2. Students should note that certain fees are non-refundable before their course commences including any Privacy Policy (available at www.college.adelaide.edu.au/privacy/).
accommodation placement fee and airport pick up fee. Students should also note certain fees are not refundable after
their course commences including library or facilities fees, health insurance fees and administration fees such as courier 7.8. Accepts liability for payment of all relevant fees identified in these Terms and Conditions, the College brochure
fees, course transcript reprint fees and late fees. In all cases, the enrolment fee, medical insurance and/or health cover and on the College (or the University of Adelaide) website.The student also understands the circumstances in which
costs (to date), accommodation placement fee (if the accommodation has already been arranged), courier and any other refunds will not be applicable as set out in these Terms and Conditions, including the College’s Refund Policy, and that
service fees are non-refundable. fees may increase with written notification from the College during the course. For international students, the student
has also read the information provided in relation to living expenses and they understand that the cost of living in
4.3. Full tuition fee refunds are payable if: Australia may be higher than in their own country, and the student confirms that they can meet those costs.
•The College is unable to provide the course before, or on the day of, the published course commencement date; 7.9. Understands and agrees to abide by all the College policies and procedures (available at www.college.adelaide.
• The offer of enrolment is withdrawn for reasons other than incorrect or incomplete information supplied by the edu.au/policies/).
student at the time of enrolment; 7.10. Agrees to notify the College of their contact details, including their current residential address, mobile number
• An Australian visa application is refused;Where a student visa application is rejected, all tuition fees paid will be (if any) and email address, and who to contact in emergency situations. The student also agrees to notify the College of
refunded in full less enrolment fee once proof of visa refusal has been provided to the College; or any change in those details within 7 days of the change. The following websites may be of use for international students:
• Approval of an Australian student visa is delayed beyond the student’s control. • Education Services for Overseas Students (ESOS): internationaleducation.gov.au
4.4. Partial tuition fee refunds are payable in the following manner: • Department of Home Affairs: www.homeaffairs.gov.au
• 90% of the tuition fee is refundable when the offer of enrolment is withdrawn because of incorrect or incomplete • Australian Department of Foreign Affairs and Trade: www.dfat.gov.au
information supplied by the student at the time of enrolment; • Australian Quarantine and Inspection Service: www.agriculture.gov.au
• 80% of the tuition fee is refundable when the student notifies the college of their decision not to enrol at least 4 weeks • The Bureau of Meteorology: www.bom.gov.au
before the published course commencement date; or
• Overseas Student Ombudsman: www.ombudsman.gov.au
• 50% of the tuition fee is refundable when the student notifies the college of their decision not to enrol less than 4
weeks before the published course commencement date. • Office of the Training Advocate (SA only): www.trainingadvocate.sa.gov.au
4.5. No tuition fee refund is payable if:
• The College receives written notification of cancellation of enrolment for a student after the published
commencement date of the student’s course;

college.adelaide.edu.au Foundation Studies, Degree Transfer and Pre-Master’s programs

(The University of Adelaide) CRICOS 00123M | English language programs
(Kaplan) CRICOS 03127E.