188宝金博页面版

VU STUDENT ID (if applicable)PERSONAL DETAILSTitle (Mr/Mrs/Miss/Ms) : Family name (as stated in passport) :Given names (as stated in passport) :Gender (M/F) : Country of birth: Date of birth (day/month/year) :Citizenship (as stated in passport) : Passport No.:Please attach a photocopy of your photo ID page from your passport.ADDRESS FOR CORRESPONDENCENumber and street:Suburb or town: State/Province:Postcode/Zip code: Country: Phone: Fax:Email:Are you applying through a Victoria University’s registered representative? ? Yes ? NoIf yes, please indicate representative name:PERMANENT HOME ADDRESS (if different from above)Number and Street:Suburb or Town: State/Province:Postcode/Zip code: Country: Phone: Fax:Email:COURSE PREFERENCEIndicate the course you are applying for:? Certificate/Diploma/Advanced Diploma ? Undergraduate ? PostgraduateIn order of preference, list the courses you are applying for (refer to the list of ‘courses and fees’ at the back of VU’s international course guides orvisit WWW.VU.EDU.AU/INTERNATIONAL).Course name: Course Code Campus Commencing Semester and Year(e.g. HBED) (e.g. FP) (e.g. Semester 1, 2007)123Do you intend to undertake further study after you complete your proposed course? ? Yes ? NoIf yes, please indicate the further study course you intend to apply for:Course name: Course code:Tag __________________________________________________Interviewed by ________________________________________Date ________________________________________________INTERNATIONALSTUDENTAPPLICATIONFORM• Enclose a non-refundable AUD$50 application fee. Note: currently enrolledVU students or VU alumni are exempted from the application fee.• All documents must be certified by a recognised authority (i.e. school,university, Victoria University representative).• For more information see the ‘How to Apply’ section of VU’s internationalcourse guides.• This form should not be used by permanent residents or citizens of Australiaor citizens of New Zealand.For office use onlyRepresentative StampVU’s registered representative contact details can beviewed at: WWW.VU.EDU.AU/INTERNATIONALCRICOS PROVIDER NO.: 00124K