GENUINE STUDENT ASSESSMENT FORM

Curtin University is required to assess applicants for admission against the Department of Home Affairs (DHA) Genuine Temporary Entrant and Genuine Student
criteria (https://www.homeaffairs.gov.au/trav/stud/more/genuine-temporary-entrant).

The purpose of this form is to enable the University to make an assessment of the genuineness of an applicant’s intention to complete their studies at Curtin
University. Each question is targeting a specific area that Curtin University will base its assessment on, and the DHA may be interested in during your visa application.
To facilitate our assessment, please complete and return this form to the University. The University must be satisfied that you are a genuine student before giving you
an offer.

Instructions for completing this form

1. You must answer all the questions.
2. Any information on this form must be accurate and dates must match the supporting documents you provide.
3. The Student and Agent must sign this form (Direct applications do not need an Agent signature)
Please attach a completed copy of this form together with your International Application for Admission Form and email it to ci-apply@curtin.edu.au along with
any supporting documents.

Section 1: Student Personal Details

Family name Given names
Katuwal Gagan
Date of birth Course Title
dd/mm/yyyy 23/10/2003 Bachelor of business (Business and Techn
Curtin ID
(if known)

Section 2: Immigration History

a. Have you ever had your visa denied, cancelled or been deported by the immigration If yes please provide details below. You
department of Australia, the United States of America (USA), Canada, United No Yes should also attach copies of your visa
Kingdom, New Zealand or any other country? rejection, cancellation or deportation notice
with this form

Section 3: Your Choice of Study/Course

Please note: it is in your best interests to do thorough research and understand why you are choosing the course you would like to study at Curtin University. For
more information on courses please visit: http://courses.curtin.edu.au/. Your family members or agent can provide advice, but the final decision should be made by
you. Once you arrive in Perth, course switching/changing your course may not be possible. Not being able to course switch or change your course are not grounds for
requesting to be released from Curtin University.
a. Why are you coming to study at Curtin University?
Curtin University is known for its high-quality education and reputable academic programs among
international students. The university is consistently ranked top 1% of universities in the world. Also,
Curtin offers a wide range of undergraduate and post-graduate courses with a strong focus. Specifically,
Curtin is involved in diverse research areas which offers chance for students to engage in research projects.
b. Why do you want to study the course/s you have applied for at Curtin University?

Studying Bachelor of business (Business and Technology) at Curtin University will be the right course for
me because I have always set my genuine interest in both business concept and technological
advancements. Also, Curtin University has a strong reputation for its business and technology programs, it
will provide me a high qualty education, resources and a credible degree that employers respect.
c. Why are you not undertaking this course in your home country?

d. How is this course relevant to your future career and educational plans?

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e. Have you received a Confirmation of Enrolment (CoE) from another institution before? No Yes If yes please provide details below.

Date CoE Issued (dd/mm/yyyy) Name of Institution Reason for withdrawing your acceptance from the institution

f. Have you previously studied in Australia? No Yes If yes please provide details below.

Start Date End Date

(dd/mm/yyyy) (dd/mm/yyyy) Name of Institution Which course?

Section 4: Gaps in your Studies

a. Have you had any gaps of more than 3 months during your studies and/or career? No Yes If yes please provide details below.

Dates (dd/mm/yyyy) to (dd/mm/yyyy) Details of gap

Jan 2023 to March 2023 PTE preparation and Exam

April 2023 to July 2023 Basic Computer course training at

Section 5: Marital Status

a. Are you married? No If no please go to Section 6. Yes If yes please provide details below.

Spouse Name Spouse Date of Birth Spouse Passport Number Date of Marriage Will your spouse be joining you in
(dd/mm/yyyy) (if available) (dd/mm/yyyy) Australia ?

No Yes

b. Has your spouse ever had a visa denied, cancelled or been deported by the If yes please provide details below. You
immigration department of Australia, the United States of America (USA), Canada, No Yes should also attach copies of the visa
United Kingdom, New Zealand or any other country? rejection, cancellation or deportation
notice with this form

c. What is your spouse’s highest qualification? (e.g. Diploma, Bachelor; Masters etc). Please provide copies of the qualifications with this form.

Name of Qualification Name of Institution Year started and year completed

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d. Is your spouse currently employed? Please attach a detailed CV. No Yes If yes please provide details below.

Name of Company Job Title Year started

e. Do you have any children? No Yes If yes please provide details below.

Name of Child Date of Birth Passport Number Will this child be joining you in
(dd/mm/yyyy) (if available) Australia ?

No Yes

No Yes

No Yes

No Yes

Please note: if your spouse travels to Australia, they will be required to abide by the conditions stipulated on your student visa. If your spouse opts to move to
another city to work or study, Curtin University may not consider that as sufficient grounds for release from the University.

Section 6: Other Family and Relatives

Adjusting to living in a new country can be difficult. Community and family support can be great support when adjusting to your new environment. If you have
relatives and friends in other cities other than Perth, it may be in your best interest to apply and study in that city. Should you choose to come study at Curtin
University in Perth, we will ensure that you get a smooth transition.

As a Curtin University student you will have access to a wide range of services including orientation sessions, health and counselling services and academic support
services. You can get more information about the support services provided at https://international.curtin.edu.au/pre-departure/support-services/

a. Do you or your spouse have any relatives currently living in Australia? This includes siblings,
No Yes If yes please provide details below.
parents, grandparents, children, aunts, uncles and cousins.

Name of Relative Relationship to you? City of Residence? Visa Type?

(e.g. Citizen , Permanent Resident or Student Visa)

Please note: If you have relatives living in a city other than Perth, we strongly advise you to study in that city. If you opt to study with Curtin University in Perth and
then request a release to move closer to your relatives, the University may not consider it sufficient grounds for release. You will be required to continue with your
course at Curtin University and make use of the transitional support services available to all students.

b. If you are coming to study in Perth, Western Australia and your relatives live in another city, please explain below why you have decided not to study in
the city or location where you already have relatives

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Section 7: Ability to afford to live and study at Curtin University in Perth
In order to be granted an Australian student visa, you must have access to sufficient funds to meet your tuition and living costs for the entire duration of your studies.
As international students are only allowed to work 40 hours per fortnight and getting part time work is not guaranteed, you will not be able to rely on this to cover
your tuition and living expenses. Curtin University will not consider inability to raise your tuition fees and living expenses as grounds for release from the University

For more information about tuition and living costs in Australia please see:

1. Curtin University Student Fees information - http://futurestudents.curtin.edu.au/fees-charges/;

2. Curtin University advice on budgeting - http://international.curtin.edu.au/pre-departure/budget/; and
3. Australian Government information on living costs - http://www.studyinaustralia.gov.au/global/live-in-australia/living-costs .

a. What do you expect your total expenses to be for the duration of your stay in Australia (including the costs for any dependants if applicable)? Please base
your calculations on the information provided by the Dept. of Home Affairs at: https://www.homeaffairs.gov.au/trav/stud/more/student-visa-living-costs-and-
evidence-of-funds

Tuition Fees Living Costs Total Cost Tuition Fees Living Costs Total Cost
(in $AUD) (in $AUD) (in $AUD) (in local currency) (in local currency) (in local currency)
Yourself

Dependants
Including and children (if any)

Total

Living costs are a minimum amount required for visa purposes. Living costs vary depending on where you will be living and studying. It is your responsibility to
determine and cover your costs whilst living and studying in Australia. You must not rely on work to support yourself in Australia as a student.

b. How will you pay for your tuition, living expenses and travel arrangements to Australia? Please provide details below. Please note that in some cases you may
be required to provide bank statements/loan documents. If you are a sponsored student, please provide financial guarantee from your sponsor.

My parents are going to sponsor me financially for my tution, living expenses and travel arrangements to
Australia. My sponsors are my father, mother and grandfather.

Student Declaration
• If you are under 18 years of age this form must be signed by your parent or legal guardian.

• I declare that I am a genuine temporary entrant and genuine student.

• I declare that the information and documentation provided in and with this form:

• is a true, accurate and complete representation of myself and my history. I understand that no further documents can be submitted after an
assessment decision is made;
• does not include any false or misleading information; and
• I understand that giving false or misleading information is a serious offence under Australian law and will impact negatively on my
application to study in Australia.

• I declare that the course I have chosen to study at Curtin University is my decision and not my agent’s..

• I agree that Curtin University can vary or reverse any decision made on the basis of any incorrect, incomplete, fraudulent or misleading information
that I have provided. This may result in my enrolment being terminated.

• I agree to tell the University immediately if there is any change to the information I have given in this application.

• I am aware that my spouse is required to abide by my student visa conditions as he/she is a dependent on my visa.

• I declare that if my spouse moves to another city, I am aware that it is not grounds for release letter because I am required to maintain my
enrolment as per my visa conditions.

• I understand my obligation to have sufficient funds to pay for Overseas Student Health Cover, all tuition fees and associated student costs and all
living and travel expense for myself and any dependent/s (if applicable) for the entire duration of my stay in Australia.

• I understand that if I am unable to pay my tuition fees in line with the payment due date, Curtin University may cancel my enrolment which may
affect my student visa.

• I understand that while, as part of my student visa, I am allowed to work a maximum of 40 hours per fortnight (with unlimited work-rights during
semester breaks), these funds are to be used to supplement my living costs but must not be my only source of income to pay my tuition fees and
living expenses.

• I understand that my visa may be rejected or cancelled by the Department of Home Affairs (DHA) if it is determined that documents supporting my
application are fraudulent or I have made a false declaration.

• I understand that my visa application will be denied if I do not pass DHA’s health and character checks.

• I understand that my visa application will be rejected if DHA is not satisfied that I am a genuine student – https://www.homeaffairs.gov.au/trav/
stud/more/genuine-temporary-entrant

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 • I understand that my visa may be cancelled by DHA if I do not abide by the conditions of my visa. Please go to the following link for more
information: https://www.homeaffairs.gov.au/trav/stud/more/visa-conditions

• I understand that I will be required to update any changes to my personal details direct to the Curtin University Student System within seven days of
my arrival in Perth. These details will only be passed onto DHA when requested by DHA.

• I fully understand the Curtin University Refund Policy - http://fees.curtin.edu.au/documents/RefundAgreement_International_Students.pdf

• I fully understand that if I request a transfer to another provider (release letter) within the first six months of my study, Curtin University may refuse
my request - https://www.homeaffairs.gov.au/trav/stud/more/changing-courses

• I full understand that if I decide to downgrade i.e. go to a course that has a lower AQF level I will not be released from the university and will be
required to apply for another visa - https://www.homeaffairs.gov.au/trav/stud/more/changing-courses

• I confirm that my agent has not completed this form on my behalf.

• I understand that if I defer, Curtin University cannot guarantee that all majors and courses will be available for the requested intake

• I confirm that I have disclosed all documents required for Curtin’s assessment and these are a valid and accurate representation of myself and my
history. I understand that no further documents can be submitted after an assessment decision is made.

• I understand that if I am unsuccessful in my visa application Curtin University may not issue another offer and Confirmation of Enrolment

• I understand that if I am unsuccessful in the genuine temporary entrant (GTE) assessment a 2 year application exclusion from Curtin University
may apply.

Gagan Katuwal
Print name Signature Date (dd/mm/yyyy)

Agent Declaration
• I confirm that I did not complete this form on behalf of the student.

• I declare that the course on this application form is the student’s choice.

• I declare that I have assessed and sighted all of the attached documents. I have made every effort to verify the authenticity and validity of the
documents which form part of this application.

• I declare that to the best of my knowledge this is an accurate and valid representation of the student.

• I declare that all the information that has been provided to me from the student has been disclosed to Curtin University.

• I understand that no further documents can be submitted after an assessment decision is made.

• I declare that I have informed the student that if they request for a transfer to another provider (release letter) within the first six months of my
study, Curtin University may refuse their request - https://www.homeaffairs.gov.au/trav/stud/more/changing-courses

• I declare that I have informed the student that if they decide to downgrade i.e. go to a course that has a lower AQF level I will not be released from
the university and will be required to apply for another visa - https://www.homeaffairs.gov.au/trav/stud/more/changing-courses

• I acknowledge that if the student is unsuccessful in the genuine temporary entrant (GTE) assessment a 2 year application exclusion from Curtin
University may apply.

• I understand that if the student is unsuccessful in his/her visa application Curtin University may not issue another offer and Confirmation of
Enrolment

Agent Stamp

Print name Signature

Date (dd/mm/yyyy)

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