Application for Enrolment International

Preferred Course Start Date:

Faculty of Information Technology & Telecommunications:ICT30118 Certificate III in Information, Digital Media and TechnologyICT40418 Certificate IV in Information Technology NetworkingICT50418 Diploma of Information Technology NetworkingICT51015 Diploma of Telecommunications Network Engineering

Faculty of Business and Management:BSB40215 Certificate IV in BusinessBSB50215 Diploma of BusinessBSB51918 Diploma of Leadership and ManagementBSB61015 Advanced Diploma of Leadership and Management

Faculty of Hospitality Management:SIT30816 Certificate III in Commercial CookerySIT40516 Certificate IV in Commercial CookerySIT50416 Diploma of Hospitality ManagementSIT60316 Advanced Diploma of Hospitality Management

I would like to pay half of the fee of above course(s) before the start of the course(s)I would like to pay more than half of the fee of above course(s) before the start of the course(s)
a student can pay full fees if they wish to, but they are not required to pay more than 50 percent up front

Nationality:

Email Address:

Address:

Relationship to Applicant:

Attach a separate sheet with above information, if more than two accompanying dependents.

Do you speak a language other than English at home?

How well do you speak English?Very wellWellNot wellNot at all

In which country were you born?

Are you of Aboriginal or Torres Strait Islander origin?
(For persons of both Aboriginal and Torres Strait Islander origin, mark both “Yes” boxes)
NoYes, AboriginalYes, Torres Strait Islander

Do you consider yourself to have a disability, impairment or long-term condition?:NoYes

(If Yes, please specify the areas of disability, impairment or long-term condition. You may indicate more than one area. Please attach documentation describing your disability, impairment or long-term condition in more detail.)
Hearing/DeafIntellectualMental IllnessMedical conditionPhysicalLearningVisionAcquired brain impairmentOthers

Are your still attending secondary or senior secondary education?YesNo

List score and date of English tests

Do you require any language, literacy or numeracy assistance? YesNo

Are you seeking Credit Transfer /Recognition of Prior Learning? YesNo

If YES, Application for Credit Transfer/Recognition of Prior Learning along with relevant supporting documents must accompany this application form.

If you believe you have any relevant employment experience, attach details on a separate sheet.

Which best describes your current employment status? (Tick ONE box only) Full-time employeeSelf-employed – employing othersPart-time employeeSelf-employed – not employing othersNot employed – not seeking employmentUnemployed – seeking part time employmentEmployed- unpaid worker in a family businessUnemployed –seeking full time employment

(Tick ONE box only) To get a jobTo develop my existing businessTo start my own businessTo try for a different careerIt was a requirement of my jobI wanted extra skills for my jobTo get into another course of studyFor personal interest or self-developmentTo get a better job or promotionOther reasons

Imperial 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.
USI No:

Education provider’s use VEVO to check on your entitlement to live, work and study in Australia
For The Imperial College of Australia to obtain this information we require your permission for us to conduct a VEVO check on yourself

I permit The Imperial College of Australia to conduct a VEVO check

If you were referred by an Education Agent, please provide details below.

Privacy Notice

Under the Data Provision Requirements 2012, BJSB Pty Ltd T/A The Imperial College of Australia 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 The Imperial College of Australia for statistical, regulatory and research purposes. The Imperial College of Australia 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 a VET Statement of Attainment or VET 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 program 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).

Student Declaration and Consent

I declare that the information I have provided to the best of my knowledge is true and correct.

Parent/Guardian consent is required for all students under the age of 18.

I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above.

I acknowledge that I have read and understood the information provided in this form. I also acknowledge that I have read Imperial College student prospectus, marketing material, and received full information from The Imperial College of Australia’s and/or its Education agent (in case of enrolment through education agent) before making the decision to enrol in the course(s). I agree to abide by the above terms & conditions. The information and documents provided by me are true, genuine and correct in all respects.

Date: