APPLICATION FOR ADMISSION

Transcription

1 APPLICATION FOR ADMISSION HOW TO COMPLETE THIS FORM 1. Please print boldly using block letters. All sections must be completed. 2. Use a black pen to fill out this form. 3. Fill-out in CAPITAL / UPPER-CASE. 4. Enclose one set of supporting documents with this application. (All documents must be certified by a recognised authority, eg school, university or Monash South Africa representative.) This application will not be processed unless full documentation is attached. Fax copies are NOT acceptable. 5. This application is the property of Monash South Africa. Supporting documentation will NOT be returned. 6. Late applications will be accepted subject to availability of places. 7. A non-refundable application fee of R350 must be paid when you submit this form. STUDENT NUMBER: (For admin purposes) AGENT / REPRESENTATIVE STAMP: RETURN COMPLETED FORM TO: musa-admissions@monash.edu PERSONAL DETAILS Surname: SA ID Number or Passport Number: Date of Birth: Day / Month / Year Citizenship: Given Names: Sex: Female Male Parent / Guardian Name: Country of Birth: 1. Do you have any physical and/or other disabilities or medical conditions that Monash should be aware of: Yes No If so please specify: For more information on Disability Support, contact Student Development 2. If you are not a South African citizen, do you have permanent residency in South Africa? Yes No 3. Have you previously applied to Monash South Africa? Yes No If yes, provide your Monash Student Number: ADDRESS DETAILS Postal Address: Home Address: Postal Code: Postal Code: Country: Country: Tel: Home ( ) Business: ( ) Cellphone: Fax: Home ( ) Business: ( ) Emergency Contact Person Cellphone: Address (please write clearly): Alternate Address (Parent/Guardian): PERSON RESPONSIBLE FOR PAYMENT OF FEES Full Name: Address: Postal Address: Country: Tel: Cell Tel: Home Postal Code: PROGRAMME PREFRENCES - Programme applying for (select below) STARTING DATE: Year in which you wish to begin your course: Semester 1 Semester 2 Foundation Programme Stream: Social Science Business IT Health Law Science Diploma in Entrepreneurial & Small Business Operations Bachelor of Social Science Bachelor of Business Science Bachelor of Business Science (specialising in Accounting) Bachelor of Commerce in Law Bachelor of Computer and Information Sciences Bachelor of Engineering Electrical and Electronic Engineering Bachelor of Public Health Monash South Africa reserves the right to amend intake arrangements. Monash South Africa Limited incorporated in Australia External Profit Company is registered as a private higher education institution under the Higher Education Act of Registration number: 2000/HE10/00 1

2 APPLICATION FOR ADMISSION PROGRAMME PREFRENCES CONTINUED - Programme applying for (select below) HONOURS AND ADVANCED DEGREEES Honours Programme Stream: Social Science Business IT Health Honours Discipline (area of study) Bachelor of Laws (LLB) ENGLISH LANGUAGE PROFICIENCY Was English the language of instruction in previous studies completed? Yes No If no, I will sit/have sat for English language proficiency test: English test name: TOEFL IELTS Date taken: Day / Month / Year Result (If known): TRF number: SECONDARY AND POST SECONDARY STUDIES SECONDARY STUDIES Name of qualification School Country Year completed * Are you currently attempting final year qualification? Yes No If yes, please indicate the date results will be available: Day / Month / Year Name of exam School Examination Number Centre TERTIARY STUDIES Year of commencement: Degree/Qualification: Institution: Country Year completed/or last attempt Original or certified copies of statements / transcripts must be submitted and must include failures (if any). Are you currently awaiting results of post-secondary studies undertaken this year Yes No If yes, please indicate the date the results will be available: Day / Month / Year Name of institution and qualification: To apply for credits for previous study, complete the application for advanced standing form available at IMPORTANT CHECKLIST To be completed by all applicants Have you written your address clearly? Have you completed the application form in full? Office use only Have you attached a certified copy of your Identity Document? Have you included original or certified copies of results, qualifications, transcripts and English language proficiency, etc? Have you signed and dated the application form? Have you paid the non-refundable application fee of R350? Monash South Africa reserves the right to amend intake arrangements. Monash South Africa Limited incorporated in Australia External Profit Company is registered as a private higher education institution under the Higher Education Act of Registration number: 2000/HE10/00 2

3 APPLICATION FOR ADMISSION TERMS AND CONDITIONS 1. I have read MSA s rules, statutes, regulations, policies and procedures and the relevant course information provided including course structure and requirements and undertake to abide thereto. 2. I warrant that the information I have entered on the application form, or provided in support of my application, is correct and complete. 3. I acknowledge that the provision of incorrect information or the withholding of relevant information relating to my application, including academic transcript/s may result in MSA refusing to assess my application, withdrawing an offer of a place or cancelling my enrolment. 4. I agree to pay all fees and charges due and payable by me to MSA, which includes: 4.1 any arrears and interest on arrears; 4.2 and any costs of recovery, including attorney-and-client scale fees and/ or collection commission; 4.3 fees even if I do not make use of MSA s facilities if I do not inform MSA in writing of withdrawal from studies or a course by the prescribed date(s). 5. I am aware that I am required to pay a non-refundable application fee of R350 when I apply which will not be refunded if my application is successful, nor will it be allocated toward my tuition fees when I proceed to enrol. 6. I am aware of the estimated total course fees at MSA and living costs. I understand that the total course fees do not cover the cost of books, materials, field trips or any additional cost related to my course, unless otherwise specified. 7. Should MSA determine that I have submitted incorrect information or a false document, I consent to MSA disclosing this information to other relevant tertiary institutions. 8. I consent to any educational institution at which I have been a student and/ or my current or any past employer, providing MSA with information which that institution or employer holds about me for the purpose of MSA verifying my attendance, conduct, grades and/or qualifications or experience in order to assess my eligibility for an offer and/or enrolment. 9. I understand that if any educational body or institution does not supply these records, it may impact the assessment by MSA of my application. 10. I agree that MSA may cancel my admission if its continuation may, in the option of MSA, place MSA in breach of any applicable law, including any law that implements UN sanctions. 11. I have read MSA s statement on privacy and the purposes for which my personal information will be used and I understand, accept and agree that MSA: 11.1 may keep and process data and documents in electronic format, including the personal data supplied by me in any admission form and my image and fingerprints (both to be used solely for identification purposes); 11.2 may use and transfer such data and use such documents in electronic or other formats, including submission of data for the National Learners Record Database and other returns as required by the Department of Higher Education and Training; 11.3 may place my records of qualifications awarded in the public domain; 11.4 may process my personal information in accordance with its rules and policies for academic and administrative purposes, including disciplinary processes and that MSA may use electronically generated documents in place of the originals signed by me. For international students intending to study at MSA, the following applies in addition to the above declaration statement: 12. I declare to have sufficient funds to support myself and my family unit members (if applicable) for the TOTAL period of my studies including proposed course fees for myself and any school-aged family members, Overseas Student Health Cover, living costs and travel costs, regardless of whether my dependents intend to accompany me. 13. I declare that I am medically and physically fit to undertake full time studies. 14. I declare that I am aware of the applicable study visa requirements to commence with my studies at MSA. In the event MSA forms the opinion that I did not adhere to the visa requirements MSA may refuse to assess my application, withdraw an offer of a place or cancel my confirmation of enrolment. 15. I waive all claims against MSA and indemnifies MSA of any damage or loss suffered from whatsoever cause arising while I am, or as a consequence of me being a MSA student. 16. If I am a minor, I have the consent of my parent(s) / guardian to submit this form. Signature : Date / / Day Month Year OFFICE USE ONLY P CO O R P CO O R Application checked and captured: Decision: Decision: MSA Representative Name: Sign: Sign: Admission Staff Name: Date: Date: CRM Unique Code: Captured by: Captured by: Date Received: Letter date: Letter date: Source: Online Walk-In Open Day Post Other Note: Note: Monash South Africa reserves the right to amend intake arrangements. Monash South Africa Limited incorporated in Australia External Profit Company is registered as a private higher education institution under the Higher Education Act of Registration number: 2000/HE10/00 3

4 2018: RADIO 702 SCHOLARSHIP APPLICATION FORM COURSE: BACHELOR OF ELECTRICAL AND ELECTRONIC ENGINEERING (3677) (Application must be submitted on or before 31 January 2018) APPLICANT S PERSONAL DETAILS Title (Mr/Miss/Mrs/Ms): Name & Surname: ID/Passport No: Contact No (H): Contact No (Cell): Home Address: APPLICATION REQUIREMENTS DETAILS OF SCHOLARSHIP Meet entry requirements to commence course 3677 for first time in 2018 with a minimum GPA of 4 and have received an offer to enrol as a full time student at MSA for course Must be a commencing student with an Achievement Level of 40 and above. Be studying Year 12 or equivalent (SA citizen) or be studying in the final year of secondary school/equivalent (international). Enrol each semester for full load as per course structure. Be able to demonstrate that the additional costs of textbooks, stationery, printing costs, living expenses, accommodation and travelling costs can be covered at the student s own cost. The student must be self-sponsored and not sponsored by a company/organization. For detailed terms and conditions for this scholarship please visit 100% tuition fee Scholarship for course 3677 for Award is available to 1 student who enrolls for course 3677 with a minimum GPA of 4 and apply for this Scholarship. The student must meet academic progression during each year to qualify for the Scholarship. The following award scale is used: GPA : 50% tuition fee Scholarship GPA : 75% tuition fee Scholarship GPA 4: 100% tuition fee Scholarship The award will be revoked in the event that a student cancels his/her enrolment. Students who receive the award are not eligible for other discounts in addition to this award. The award is in the form of an automated credit note to a student s tuition fee account. No cash is transferred to a students personal bank account. Your course application form and award application form and all supporting documents must be submitted on or before 31 January 2018 to be eligible for the Scholarship.

5 SUPPORTING DOCUMENTATION TO ATTACH TO THIS APPLICATION FORM The following documents need to be attached to the application form if you apply for the Engineering Scholarship: Certified copy of Identification document/passport. Certified copy of latest academic results (if your final Grade 12 results are not yet available we will assess based on your Grade 11 or record exam results and issue a Conditional Offer pending your final results). Motivational letter by applicant, stating why you should be considered for this Scholarship (maximum 700 words). Reference letter from independent external party i.e. School / Church, motivating why applicant should be considered for this Scholarship. Note: If you do not supply all required supporting documentation your application will be rejected immediately I certify that I have read and agree to be bound by the application requirements set out above. Name & Surname: Signature: Date: Office Use Approved by: Checked all requirements: Award Value: Date: Please return your Program application form and Award application form and all Supporting documents to musa-inquiries@monash.edu

6 Payment Methods for Application Fee (R350 non-refundable) Cash payments are not accepted at the Student Administration Centre (SAC). OPTION PAYMENT TYPE Pay Online ( Pay online provides access to payment of application fee, tuition, residence, short courses and conference fees using your credit card (includes VISA, Master credit cards and non-pin debit cards). Reference number: APP-SURNAME-DATEOFBIRTH (DD/MM/YY) Please note that library fines, printing, textbooks, off campus residence fees and living allowances cannot be paid to Monash South Africa via Pay Online. In person at SAC At First National Bank in South Africa or by telegraphic transfer within your home country# Credit/Debit card (Visa, Mastercard or Diners Club) Pay to Monash South Africa, First National Bank, Cresta Branch (254905) Account number: Swift code: FIRNZAJJ Reference number: APP-SURNAME-DATEOFBIRTH (DD/MM/YY) Take note: Attach a copy of your proof of payment of your application fee to your application form.