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STUDENT APPLICATION FORM
PERSONAL DETAILS
First Name
*
Last Name
*
Date of Birth
*
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Gender
*
Male
Female
Country of Birth
*
Nationality
*
Passport Number
*
Passport Expiry Date
*
Visa Type
*
Student
Tourist
Working Holiday
Resident
Other
Other
CONTACT DETAILS
Street Address
*
Suburb/Area
*
State/City
*
Post Code
*
Country
*
Phone Number
*
Email Address
*
EMERGENCY CONTACT DETAILS
Emergency Contact Name
*
Relationship
*
Phone Number
*
EDUCATION BACKGROUND
What is your highest level of study
*
Year of completion
*
Total number of years of study
*
Are you studying now
*
Yes(please specify details in the next section)
No
DETAILS OF YOUR CURRENT STUDY
Course name
Institute Name
State/Country
Start date
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End Date
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ENGLISH LEVEL
Please specify your current English Level
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Beginner
Elementary
Pre-Intermediate
Intermediate
Upper-Intermediate
Advanced
Have you ever completed any of the following English Tests: IELTS, TOEFL, TOEIC, PET
*
No
Yes(please specify below)
Test Name
Results
Year
Unique Student Identifier (USI)
Do you have a Unique Student Identifier
*
No
Yes(please specify)
Yes(please specify)
If you don't have a USI, do you want Focus Learning to apply for a USI on your behalf
No
Yes
NOTE: If you have a genuine personal objection to being assigned a USI, you can apply for an individual exemption from USI to the Student Identifiers Registrar for information on a USI exemptions, including individual exemptions, please
Click Here
COURSE SELECTED
Please specify the course(s) you wish to study
*
ELICOS – General English (GE) – I (10 Weeks) (CRICOS Code: 096641F)
ELICOS – General English (GE) – II (10 Weeks) (CRICOS Code: 096642E) *
ELICOS – English for Academic Purpose (EAP) – I (10 Weeks) (CRICOS Code: 096643D) *
ELICOS – English for Academic Purpose (EAP) – II (10 Weeks) (CRICOS Code: 096644C) *
BSB42015 – Certificate IV of Leadership Management (CRICOS Code: 097771C)
BSB42415 – Certificate IV in Marketing and Communication (CRICOS Code: 096152A)
BSB50215 – Diploma ofBusiness (CRICOS Code: 089423G)
BSB51915 – Diploma of Leadership Management (CRICOS Code: 091983B)
BSB52415 – Diploma of Marketing and Communication (CRICOS Code: 096153M) *
BSB60215 – Advanced Diploma of Business (CRICOS Code: 089424G)
BSB61315 – Advanced Diploma of Marketing and Communication (CRICOS Code: 096154K) *
Course Start Date
*
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SUPPORT QUESTIONS
Do you have a disability, impairment or permanent medical condition that can affect your studies
*
No
Yes
UPLOAD DOCUMENTS
Passport
Highest Qualification
IELTS, PTE
Visa Copy
*
I declare that the information I have supplied in this application is true and correct.
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