International Student Application Form

PRIVACY STATEMENT
Privacy Notice
Under the Data Provision Requirements 2012, Queensford College is required to collect personal information about you and to disclose that
personal information to the National Centre for Vocational Education Research Ltd (NCVER).
Your personal information (including the personal information contained on this enrolment form and your training activity data) may be
used or disclosed by Queensford College for statistical, regulatory and research purposes. Queensford College may disclose your personal
information for these purposes to third parties, including:
• School – if you are a secondary student undertaking VET, including a school-based apprenticeship or traineeship;
• Employer – if you are enrolled in training paid by your employer;
• Commonwealth and State or Territory government departments and authorised agencies;
• NCVER;
• Organisations conducting student surveys; and
• Researchers.
Personal information disclosed to NCVER may be used or disclosed for the following purposes:
• Issuing statements of attainment or qualification, and populating authenticated VET transcripts;
• Facilitating statistics and research relating to education, including surveys;
• Understanding how the VET market operates, for policy, workforce planning and consumer information; and
• Administering VET, including programme administration, regulation, monitoring and evaluation.
You may receive an NCVER student survey which may be administered by an NCVER employee, agent or third party contractor. You may opt out
of the survey at the time of being contacted.
NCVER will collect, hold, use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the VET Data Policy and all
NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au).
APPLICANT INFORMATION
Title Mr. Mrs. Ms. Existing student number:
First Name: Last Name:
Date of birth (dd/mm/yyyy): ____ / ____ / ________ Gender: Male Female
From 1 January 2015, we [Queensford College] can be prevented from issuing you with a nationally recognised VET qualification or statement of attainment
when you complete your course if you do not have a Unique Student Identifier (USI). In addition, we are required to include your USI in the data we submit to
NCVER. If you have not yet obtained a USI you can apply for it directly at http://www.usi.gov.au/create-your-USI/ on computer or mobile device. Please note that
if you would like to specify your gender as ‘other’ you will need to contact the USI Office for assistance
Enter your Unique Student Identifier Number (USI) (if you already have one):
CONTACT DETAILS
Current Address: Suburb:
Postcode: State:
Home phone: Mobile phone:
Email address:
EMERGENCY CONTACT DETAILS
Name: Relationship:
Address: Email:
Home Phone: Mobile Number:
LANGUAGE AND ENGLISH PROFICIENCY
Country of birth: Citizenship:
Is English your first language?  Yes    No    If not, what is your first Language?:
If not, please indicate the English test you completed. IELTS    TOEFL PTE(A) CAE(A) (Attach evidence)
Registration number: Date: ____ / ____ / ________
Average score: Listening:     Reading:     Writing:      Speaking:
DISABILITY
Do you consider yourself to have a disability, impairment or long-term condition? Yes No If no - go to next question
If you indicated the presence of a disability, impairment or long-term condition, please select the area(s) in the following list:
(You may indicate more than one area. Please refer to the Disability Supplement on page 6 for an explanation of the following disabilities)

Hearing/deaf Physical Intellectual Learning Mental illness Acquired brain impairment Vision
Medical condition Other
BRISBANE (Head Office) PARRAMATTA ADELAIDE
Level 2, 359 Queen Street Level 3, 1 Fitzwilliam Street Level 11, 90 King William Street
Brisbane QLD 4000 Australia Parramatta NSW 2150 Australia Adelaide SA 5000 Australia
+61 7 3221 1626 +61 2 8660 0040 +61 8 8410 4605
info@queensford.edu.au sydneywest@queensford.edu.au sa@queensford.edu.au

Queensford College is the trading name of Malekhu Investments Pty Ltd ABN 17129064437 | RTO 31736 | CRICOS 03010G Reference:04102018 v5.4 October 2018
www.queensford.edu.au PAGE 1
 EDUCATION
Please fill out below your highest level of education achieved.
Qualification name: Qualification name:
Name of institution: Name of institution:
Country: Country:
Year completed: Year completed:
Language of instruction:  English   Other    Language of instruction:  English   Other   
Are you currently enrolled with another CRICOS provider? Yes    No If not, skip to the next section
If so, do you have a Letter of Release? Yes    No
Do you require a Letter of Offer to be released by your current provider? Yes    No
Why are you leaving your current course provider?
Do you owe fees to your previous provider? Yes    No
Did you abide by the conditions of your student visa with your previous provider? (Attendance and course progress) Yes    No
When did you complete your course with your previous provider in Australia? (Attach evidence)
EMPLOYMENT
Of the following categories, which BEST describes your current employment status? (Tick ONE box only)

Full-time employee Part-time employee Self employed – not employing others

Self employed – employing others Employed – unpaid worker in a family business Unemployed – seeking full-time work
Unemployed – seeking part-time work Not employed – not seeking employment
Please attach a copy of your resume. Ensure you provide your employment history starting with the latest on the top.
PASSPORT AND VISA DETAILS
Passport No: Country of Passport:
  Student Visa, subclass     Visitor Visa    Working Holiday Visa
  Other, please specify:
If applying for student visa, where will you apply:   In Australia   Outside Australia
Have you been refused entry into Australia? Yes No Have you ever breached any VISA conditions? Yes No
Have you ever had a visa application rejected including Have you been convicted of any crime or offence in
countries such as UK, USA, Canada and New Zealand? Yes No any country? Yes No

Have you been issued a protection visa in any Are you aware of work restrictions while studying in
country to date? Yes No Australia? Yes No

Are you planning to stay back in Australia after Are you bringing parent(s)/spouse/guardian with
completion of your study? Yes No you while studying in Australia? Yes No

COURSE AND CAMPUS SELECTION

Advanced Diploma of Diploma of Leadership and

Certificate IV in Business Diploma of Business
BSB40215 (CRICOS 086956C) BSB50215 (CRICOS 087227F) Business BSB60215 (CRICOS 087501D) Management BSB51915
(CRICOS 088531A)

Advanced Diploma of Certificate IV in Accounting Advanced Diploma of

Diploma of Accounting
Leadership and Management and Bookkeeping FNS60217 (CRICOS FNS40217 (CRICOS 097330B) Accounting FNS60217 (CRICOS
BSB61015 (CRICOS 088532M) 097331A) 097332M)

Certificate III in Individual Certificate IV in Ageing Support Diploma of Early Childhood

Diploma of Nursing
Support CHC33015 (CRICOS 089224D) CHC43015 (CRICOS 089225C) HLT54115 (CRICOS 096029D) Education and Care CHC40312
(CRICOS 084087D)

Diploma of Social Media Diploma of Information Advanced Diploma of

Marketing 10118NAT Technology ICT50115 Network Security ICT60215 (CRICOS
(CRICOS 092893G) (CRICOS 092401K) 096219J)

Commercial Cookery and Certificate IV in Commercial Diploma of Hospitality

Hospitality Package Cookery SIT40516 (CRICOS 092402J) Management SIT50416 (CRICOS
091045M)

Campus: Adelaide Brisbane Parramatta Course Commencement Year: Month:

BRISBANE (Head Office) PARRAMATTA ADELAIDE

Level 2, 359 Queen Street Level 3, 1 Fitzwilliam Street Level 11, 90 King William Street
Brisbane QLD 4000 Australia Parramatta NSW 2150 Australia Adelaide SA 5000 Australia
+61 7 3221 1626 +61 2 8660 0040 +61 8 8410 4605
info@queensford.edu.au sydneywest@queensford.edu.au sa@queensford.edu.au

Queensford College is the trading name of Malekhu Investments Pty Ltd ABN 17129064437 | RTO 31736 | CRICOS 03010G Reference:04102018 v5.4 October 2018
www.queensford.edu.au PAGE 2
Please visit our website for Vocational Placement Information
 APPLICANT AND FAMILY BACKGROUND
Please list your immediate family members (e.g. parents, siblings) and their current country of residence below.
Name Relationship Country of Residence Occupation

Is your family supportive of your study in Australia? Yes No

Do you have any relatives in Australia? Yes No
What is their relationship to you? What is their occupation?
In which city/state do they live? City: State:
Have you previously travelled or studied overseas? Yes No
If yes, which countries?
What is your relationship status? Single Engaged Married De Facto Separated/Divorced Widowed

If relevant, will your partner/ spouse/ children accompany you to Australia? Yes No
Do you have any dependants? Yes No If yes, what are their ages?
Will any dependants: Travel to Australia Remain at home
Have your dependants (if any) had a student visa rejected from Australia or other countries in the past. Yes No
If yes, please provide a copy of the Visa Refusal Letter.
FINANCIAL DECLARATION
What are the expected tuition fees for the duration of your chosen course? (AUD) $
Do you wish to pay more than 50% of the course/s tuition fee? Yes No
Who will be funding your study and living expenses while in Australia?
And please provide an estimate of the sponsor’s annual income in Australian Dollars. (AUD) $
Please provide evidence of your sponsors fund/ employment statement to this document.
How will you organise and access these funds?
Will you be using a bank loan to fund your studies? Yes No
If yes, have you researched the availability of funding from an approved financial institution in your home country? Yes No
Are you aware of the requirement for Overseas Student Health Cover (OSHC) for the duration of your Student Visa? Yes No
What type of accommodation will you be seeking in Queensland/Soth Australia/New South Wales?
(E.g. shared housing, institute accommodation, homestay etc.)

Are you aware about Australian Student Visa conditions? Yes No

Do you understand the Queensford College Fees and Refunds policy? Yes No
Have you read the student handbook in Queensford College and understand the conditions? Yes No
*International Student Handbook and Refund Policy can be under on our website at: www.queensford.edu.au/downloads
OSHC
Do you currently hold Overseas Student Health Cover (OSHC)? Yes No
Do you want Queensford College to organise the Overseas Student Health Cover (OSHC) for you? Yes No
If yes, please specify your cover status: Single Couple Family
Name of OSHC provider:
Membership no: Expiration date (dd/mm/yyyy):
Do you require airport pickup?   Yes No If yes, airport pick up fee of $180 applies

Do you require accommodation assistance? Yes No If yes, accommodation placement fee of $200 applies

BRISBANE (Head Office) PARRAMATTA ADELAIDE

Level 2, 359 Queen Street Level 3, 1 Fitzwilliam Street Level 11, 90 King William Street
Brisbane QLD 4000 Australia Parramatta NSW 2150 Australia Adelaide SA 5000 Australia
+61 7 3221 1626 +61 2 8660 0040 +61 8 8410 4605
info@queensford.edu.au sydneywest@queensford.edu.au sa@queensford.edu.au

Queensford College is the trading name of Malekhu Investments Pty Ltd ABN 17129064437 | RTO 31736 | CRICOS 03010G Reference:04102018 v5.4 October 2018
www.queensford.edu.au PAGE 3
 STUDY REASON
Of the following categories, select the one which BEST describes the main reason you are undertaking this course (Tick ONE box only)
To get a job To develop my existing business To start my own business
To try for a different career To get a better job or promotion It was a requirement of my job
I wanted extra skills for my job To get into another course of study For personal interest or self-development
Other reasons:
Please attach a personal statement with your application. Please be specific with your answers.
What made you choose Australia as a study destination and why not other countries such as the US, UK, Canada, NZ etc.?
I chose Australia as a study destination because compared to US, UK, Canada, NZ and others, the cost of living and expenses
is lower than the latter countries. I'd be able to work while studying, and that allows me to offset my expenses.

How did you hear about Queensford College, have you considered any other providers in Australia? What made you choose Queensford
College?

Why do you want to study at Queensford College and how relevant is your current qualification to the course/s that you have chosen to study
at Queensford College?

Are similar courses available in your country? If yes, please explain why you chose to study at Queensford College and not your home country?

What is your career goal and how do you think studying this course at Queensford College would help you in achieving your career goal?

What sort of job opportunities do you think you have after completing the course and where do you see yourself in the next 5 years?

Have you commenced any course that you haven’t completed? Yes No
Has your application ever been refused by any Australia Provider? Yes No

BRISBANE (Head Office) PARRAMATTA ADELAIDE

Level 2, 359 Queen Street Level 3, 1 Fitzwilliam Street Level 11, 90 King William Street
Brisbane QLD 4000 Australia Parramatta NSW 2150 Australia Adelaide SA 5000 Australia
+61 7 3221 1626 +61 2 8660 0040 +61 8 8410 4605
info@queensford.edu.au sydneywest@queensford.edu.au sa@queensford.edu.au

Queensford College is the trading name of Malekhu Investments Pty Ltd ABN 17129064437 | RTO 31736 | CRICOS 03010G Reference:04102018 v5.4 October 2018
www.queensford.edu.au PAGE 4
 APPLICABLE FOR STUDENTS UNDER 18 YEARS OF AGE (TO BE FILLED OUT BY PARENT/GUARDIAN)
If your are under 18 years of age and your parents appointed Queensford College as a guardian, you would need to stay with Queensford
College’s approved homestay and guardianship providers.
• Do you wish to appoint Queensford College as the guardian for you child? Yes No
• If yes, do you agree for your child to stay with a Queensford College approved homestay provider? Homestay fees vary depending on
your child’s requirements. Yes No If yes, homestay administrative fee of $300 applies
• Additional fee is applicable for guardianship service, do you agree to pay the fee to Queensford College approved guardianship
service provider? Yes No If yes, guardianship service administrative fee of $200 applies
It is mandatory for the parent/guardian needs to fill the CAAW (Confirmation of Appropriate Accomodation and Welfare) form and submit
it to us. Please refer to the International Student Handbook about administrative and additional fees for students under 18 years old.
STUDENT DECLARATION AND SIGNATURE
• I declare that the information I have provided to the best of my knowledge is true and correct.
• I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice on page 1.
• I understand that giving false or incomplete information may lead to refusal of my application or cancellation of enrolment.
• I give Queensford College permission to obtain official records from an educational institution that I have attended.
• I understand that Queensford College collects, stores and uses personal information only for the purposes of administering
prospective, current and graduate student admissions, enrolment and education and that the information collected is confidential
and will not be disclosed to third parties without my consent, except to meet government, legal or other regulatory authority
requirements.
• I understand that if I have applied through an approved Queensford College agent, all correspondence relating to my application will
be forwarded to that agent.
• I understand that any vocational placement undertaken as a part of any of the courses offered at Queensford College will be unpaid
for.
• I have read, understood and agree to abide by the College Refund Policy found in the Student Handbook on the website of the
College; www.queensford.edu.au.
• I understand that by signing this application form, I will be sent a letter(s) of offer for Queensford College if all admission
requirements are met.
• I agree that on acceptance of enrolment by Queensford College, I must sign and return an Acceptance to my Letter of Offer which will
be the contract of Enrolment.
• I agree that I may choose to pay more than 50% of the total tuition fees up front for the course before I commence the course that is
more than 25 weeks. The College can request 100% of the total tuition fees for short courses of 25 weeks or less.
Student Declaration and Consent
Tick here to confirm you have declared and consented to the above mentioned.

Signature of Applicant: …………………………………………………………………… Date: _____ / _____ / _____

If student is under 18 years of age parent/guardian must sign below.

Name of Parent/Guardian: Signature of Parent/Guardian:

……………………………………........... ……………………………………........... Date: _____ / _____ / _____
EDUCATION AGENT DECLARATION AND SIGNATURE

As a result of an interview and counselling session undertaken at , I hereby declare that;

• The applicant, to the best of my knowledge, has a full and clear understanding of the Genuine Temporary Entrant (GTE)
requirements to undertake study in Australia
• All information and documentation to support this application has been sighted and verified to be true and genuine
I hereby recommend Queensford College proceeds with the assessment of this application AUTHORISED SIGNATORY ON BEHALF OF
EDUCATION AGENT
Name of the assessing officer: Education Agent Business Details
Name:
Address:

Signature of Assessing Officer: ……………………………………………………… Date: _____ / _____ / _____

Application Checklist

Completed Application Form Academic certificate(s) Resume Proof of Immigration History

Copy of Passport TOEFL/IELTS Certificate Personal Statement Letter of Release (if applicable)
Copy of Visa English Course Certificate (where applicable) Proof of Finances OSHC Details (if applicable)

BRISBANE (Head Office) PARRAMATTA ADELAIDE

Level 2, 359 Queen Street Level 3, 1 Fitzwilliam Street Level 11, 90 King William Street
Brisbane QLD 4000 Australia Parramatta NSW 2150 Australia Adelaide SA 5000 Australia
+61 7 3221 1626 +61 2 8660 0040 +61 8 8410 4605
info@queensford.edu.au sydneywest@queensford.edu.au sa@queensford.edu.au

Queensford College is the trading name of Malekhu Investments Pty Ltd ABN 17129064437 | RTO 31736 | CRICOS 03010G Reference:04102018 v5.4 October 2018
www.queensford.edu.au PAGE 5
Disability Supplement Information
DISABILITY SUPPLEMENT
INTRODUCTION
The purpose of the Disability supplement is to provide additional information to assist with answering the disability question.

If you indicated the presence of a disability, impairment or long-term condition, please see a explanation in the following list below:
Disability in this context does not include short-term disabling health conditions such as a fractured leg, influenza, or corrected physical
conditions such as impaired vision managed by wearing glasses or lenses.

11 — Hearing/deaf
Hearing impairment is used to refer to a person who has an acquired mild, moderate, severe or profound hearing loss after learning to speak,
communicates orally and maximises residual hearing with the assistance of amplification. A person who is deaf has a severe or profound
hearing loss from, at, or near birth and mainly relies upon vision to communicate, whether through lip reading, gestures, cued speech, finger
spelling and/or sign language.
12 — Physical
A physical disability affects the mobility or dexterity of a person and may include a total or partial loss of a part of the body. A physical disability
may have existed since birth or may be the result of an accident, illness, or injury suffered later in life; for example, amputation, arthritis,
cerebral palsy, multiple sclerosis, muscular dystrophy, paraplegia, quadriplegia or post-polio syndrome.

13 — Intellectual
In general, the term ‘intellectual disability’ is used to refer to low general intellectual functioning and difficulties in adaptive behaviour, both of
which conditions were manifested before the person reached the age of 18. It may result from infection before or after birth, trauma during
birth, or illness.

14 — Learning
A general term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening,
speaking, reading, writing, reasoning, or mathematical abilities. These disorders are intrinsic to the individual, presumed to be due to
central nervous system dysfunction, and may occur across the life span. Problems in self-regulatory behaviours, social perception, and social
interaction may exist with learning disabilities but do not by themselves constitute a learning disability.

15 — Mental illness
Mental illness refers to a cluster of psychological and physiological symptoms that cause a person suffering or distress and which represent a
departure from a person’s usual pattern and level of functioning.

16 — Acquired brain impairment

Acquired brain impairment is injury to the brain that results in deterioration in cognitive, physical, emotional or independent functioning.
Acquired brain impairment can occur as a result of trauma, hypoxia, infection, tumour, accidents, violence, substance abuse, degenerative
neurological diseases or stroke. These impairments may be either temporary or permanent and cause partial or total disability or psychosocial
maladjustment.

17 — Vision
This covers a partial loss of sight causing difficulties in seeing, up to and including blindness. This may be present from birth or acquired as a
result of disease, illness or injury.

18 — Medical condition
Medical condition is a temporary or permanent condition that may be hereditary, genetically acquired or of unknown origin. The condition may
not be obvious or readily identifiable, yet may be mildly or severely debilitating and result in fluctuating levels of wellness and sickness, and/or
periods of hospitalisation; for example, HIV/AIDS, cancer, chronic fatigue syndrome, Crohn’s disease, cystic fibrosis, asthma or diabetes.

19 — Other
A disability, impairment or long-term condition which is not suitably described by one or several disability types in combination. Autism
spectrum disorders are reported under this category.

BRISBANE (Head Office) PARRAMATTA ADELAIDE

Level 2, 359 Queen Street Level 3, 1 Fitzwilliam Street Level 11, 90 King William Street
Brisbane QLD 4000 Australia Parramatta NSW 2150 Australia Adelaide SA 5000 Australia
+61 7 3221 1626 +61 2 8660 0040 +61 8 8410 4605
info@queensford.edu.au sydneywest@queensford.edu.au sa@queensford.edu.au

Queensford College is the trading name of Malekhu Investments Pty Ltd ABN 17129064437 | RTO 31736 | CRICOS 03010G Reference:17082018 v1 August 2018
www.queensford.edu.au PAGE 6