Please read this application form carefully and complete ALL sections ensuring that certified Phone + 61 03 9640 0301 Copies of your academic transcripts and English language assessments are attached. + 61 03 9890 3358 Application fee: AUD$200 (non-refundable). Email at- admissions@zie.edu.au Website- www.zie.edu.au Personal Details Title: Mr. Mrs. Ms. Dr. Other Gender: Male Female Family name (as passport): Date of Birth (dd/mm/yy): Given name(s): Nationality (as in passport): Telephone: - Email address: - Contact Details in Home country Address: Suburb/ Town Country: - Postcode: - Contact Details in Australia Address: - Suburb/ Town: - State: - Country: - Postcode: - Emergency Contact Details Name: - Phone Number: - Address: - Relationship to Applicant: - Medical Conditions Do you have a known disability or medical conditions? (e.g. intellectual, hearing, vision, allergy) Yes No Passport and Visa Information Passport Number: Issue Date: Visa Type: Subclass: Expiry Date: What type of visa will you be holding when you commence your studies? Student Working Holiday Tourist Other Document Name: Application Form Version: 5.0 Version Date: May 2018 Page 1 of 5
Have you applied to become a permanent residence of Australia? Yes No If yes, date of application (dd/mm/yy): Previous Academic: - 1. Qualification: - Institute Country: - Date of completion: - 2. Qualification: - Institute: - Country: - Date of completion: - English Proficiency IELTS Score: - TOEFL Score: - PEARSON Score: - Other (Please Specify): - Course Information Please list the course/s you are applying for. CRICOS Code Course Name Course Duration 086942J Certificate IV in Business 24 Weeks 089773G Diploma of Leadership and Management 52 Weeks 089774G Advanced Diploma of Leadership and Management 78 Weeks 096474E Certificate III in Commercial Cookery 52 Weeks 096475D Certificate IV in Commercial Cookery 65 Weeks 096476C Diploma of Hospitality Management 52 Weeks INTAKES: - JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV ELICOS English Programs Document Name: Application Form Version: 5.0 Version Date: May 2018 Page 2 of 5
CRICOS Code Course Name Course Duration 087673F English for Academic Purposes 1 (Intermediate) 10 Weeks 087747D English for Academic Purposes (EAP 2 Upper- Intermediate) 20 Weeks INTAKES: - JAN APR JUL OCT 097472K General English (Elementary - Upper-Intermediate) 50 Weeks 097472K General English (Elementary) 10 Weeks 097472K General English (Pre-Intermediate) 10 Weeks 097472K General English (Intermediate) 10 Weeks 097472K General English (Upper-Intermediate) 10 Weeks INTAKES: -In every 5 Weeks Generic Admission requirement: All students entering these qualifications must have an English Language proficiency level of one of the below: 18 years of age Year 11 or equivalent from overseas or hold 2 years Australian qualification Successful completed Zarah s Upper-Intermediate or IELTS 5.0 (No band less than 5.0) or Undertake an English Placement Test at Zarah How did you hear about Zarah? Internet / Website Expo/ Event Friends Agent Other Course Credit (Applicable for VET courses only) Yes, (If yes, please provide copies of your academic transcripts) No Agent Details Document Name: Application Form Version: 5.0 Version Date: May 2018 Page 3 of 5
Agent Name: - Contact No: - Address: - Overseas student health covers (OSHC) Do you require OSHC? No Yes, single cover. Yes, couple covers Yes, family cover. Application checklist Completed all sections of the application form Attached certified copies of your academic qualifications (and English translation) Attached evidence of English language proficiency Included certified copy of your passport Included certified copy of your visa (if applicable) Included relevant employment details (if applicable) AUD$200 non-refundable application fee Declaration 1. I declare that the information contained in this application is true. 2. I confirm that I have received and read a copy of Zarah s current prospectus and information available on www.zie.edu.au and fully understand the requirements of the course. 3. I consent to DIBP providing Zarah with any information about my visa status from the time of my application to the time of my departure from Australia. 3. I understand that this application form and the availability of Zarah s complaint and appeals processes do not remove my right to take action under Australia s consumer protection laws. 4. I agree that Zarah may disclose information in relation to my enrolment status, visa status, including any possible breach of visa conditions along with copies of my course progress and results to my parent/s, welfare carer, and/ or agent. 5. I understand that my photo may be used in Zarah s promotional material and consent for this to be done. 6. I confirm the information supplied on this form in relation to my study plan is true and accurate. I understand Document Name: Application Form Version: 5.0 Version Date: May 2018 Page 4 of 5
that any changes to my study plan may be considered detrimental. Signature Date Document Name: Application Form Version: 5.0 Version Date: May 2018 Page 5 of 5