Porque
Have you visited or studied in Australia previously?
Yes
Have you ever been refused a visa for entry into Australia?
No
Yes
Have you breached any visa conditions?
No
Yes
No
If yes, please provide reason:
Please provide details of family immigration history.
Are you married?
Yes
No
Yes
Is your spouse already in Australia?
NoWhat visa does your spouse hold?
What is the expiry date of your spouse’s visa?
Please provide details on all dependents who will be included in your student visa application, including their date of birth.
Name:
Date of birth: D
D/M M/Y
Y
Name:
Date of birth: D
D/M M/Y
Y
Name:
Date of birth: D
D/M M/Y
Y
Name:
Date of birth: D
D/M M/Y
Y
If youhave more than four dependents, please attach a separate sheet with any remaining dependents details.
Yes
Do you have a criminal background?
Do you have a disability?
Yes
No
If yes, please provide relevant details:
No
Note this is for support purposes only and will not affect the outcome of your application.
Do you have a medical or health-related issue that may prevent astudent visa being issued?
Yes
No
Please refer to www.immi.gov.au/allforms/health-requirements/meeting-health-req.htm
If yes, please provide details:
Have you been granted a scholarship?
Yes
No
Scholarship name:
e.g. AusAID, government or any other kind of scholarship
COURSE PREFERENCES
Please enter the correct course name as per Course Search:http://www.international.swinburne.edu.au/courses/
TAFE, UNDERGRADUATE OR POSTGRADUATE COURSES
CAMPUS
INTAKE
YEAR
e.g. Bachelor of Business
e.g. Hawthorn
e.g. February
e.g. 2011
1
2
3
FOUNDATION STUDIES
DEGREE TRANSFER
INTAKE
YEAR
Please tick
Please tick
Please tick
e.g. 2011
Business
Diploma of Business (UniLink)
February
Design
Diploma of Design (UniLink)June
Information Technology/Multimedia
Diploma of Information Technology (UniLink)
October
Science/Engineering
Diploma of Engineering (UniLink)
How is this course/s relevant to your prior studies or your future career aspirations?
Please attach a Statement of Purpose (not more than 300 words) detailing reasons for any change in career, gaps in study or work experience andintention after
completion of study in Australia. Please attach referee reports, CV or work experience details, and for some design programs, portfolio. Please refer to CourseSearch
for further details in relation to portfolio requirements: www.international.swinburne.edu.au/courses
COURSE PREFERENCES (continued)
Have you ever been excluded from any previous institution?
Yes
No
Ifyes, please provide details of the reasons and institution/country:
Please note that due to Swinburne’s obligations under Australian migration, trade and sanction laws, even if you meet Swinburne’s academic entry and selection
criteria, it is possible that Swinburne may not be able to offer you a place due to additional non-academic criteria required to meet Swinburne’s legal requirements,
whichare applied at Swinburne’s sole discretion. For further information please see:
(1) Migration Act 1958 (Cwth)
(2) Migration Regulations 1994 (Cwth)
(3) Autonomous Sanctions Act 2011 (Cwth)
(4) Autonomous Sanctions Regulation 2011 (Cwth)
Refer to http://www.immi.gov.au
Refer to http://www.dfat.gov.au/
ENGLISH LANGUAGE PROFICIENCY
Have you taken an English proficiency test within the last12 months?
Yes
No
Date of test: D
D/M M/Y
Y
If yes, please attach a certified copy of your results, or submit a certified copy as soon as possible.
Test type:
Result:
(e.g. IELTS)
(if known)
Do you intend to undertake English language studies (ELICOS) at Swinburne?
Number of ELICOS weeks:
5
10
15
20
25
Yes
30
If yes, approximate start...
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