Holmesglen International Student Prospectus 2014
Please read this application form carefully and complete ALL sections ensuring that certified
copies of your academic transcripts and English language assessments are attached.
Applications will only be considered when accompanied by the $500 Application Fee. Students
applying through accredited agents are exempt from this requirement. This form is to be used in
the application for all courses listed in the current Holmesglen International Student Prospectus.
Application Form
Part 1
Personal
Details
Part 2
Contact
Address
Part 3
Course
Preferences
Surname or Family Name
Number and Street
Gender
(M) Male
(F) Female
Given Name(s)
Suburb / Town, Country
Preferred Campus
Preferred Campus
Preferred Campus
E-mail Address
Name of Course (1)
Name of Course (2)
Name of Course (3)
Home
Phone Number
Date of Birth
Are you currently studying in Australia?
Name of the OSHC Provider (if you are currently in Australia)
If YES, what visa do you currently have?
Expiry
Date
Expiry
Date
Title (Mr, Mrs, Miss, Ms, Other)
Have you been previously
enrolled at Holmesglen Institute?
Are you a permanent resident of Australia?
Do you have any disabilities?
If YES, please specify
If you are not a permanent resident of Australia, on what type of visa will you
be entering Australia?
Yes
Yes
Country of Birth
Citizenship
Passport No.
No
No
Name of Institution
Student No.
Mobile
Phone Number
Postcode / Zipcode
Work
Phone Number
Yes
No
Yes
No
Commencing: Month/year (eg. March 2014)
Commencing: Month/year (eg. March 2014)
Commencing: Month/year (eg. March 2014)
