Student Application

St. Mary's Institutes
CRICOS: 03899E. RTO No: 45674

1. PERSONAL DETAILS

TITLE*

FIRST NAME*

MIDDLE NAME (IF APPLICABLE)

LAST NAME*

DATE OF BIRTH*

GENDER*
MaleFemalePrefer not to say

ARE YOU MARRIED?*
YesNo

Do you have any children/dependants?*
YesNo

USI NUMBER (IF APPLICABLE)

ARE YOU LODGING THIS APPLICATION FROM OVERSEAS OR WITHIN AUSTRALIA?
I AM OVERSEASI AM IN AUSTRALIA

MOBILE*

EMAIL*

ALL COMMUNICATION WILL BE DONE VIA EMAIL, SO PLEASE PROVIDE AN EMAIL THAT WILL BE CHECKED REGULARLY

2. Address in Australia

STREET ADDRESS*

STATE/TERRITORY*

SUBURB*

ZIP/POSTAL CODE*

PLEASE NOTIFY ST MARY’S INSTITUTE PTY LTD OF ANY CHANGES OF ADDRESS OR CHANGES OF OTHER CONTACT DETAILS THAT MAY OCCUR WHILE THEY ARE ENROLLED WITH ST MARY’S INSTITUTE PTY LTD

3. OVERSEAS

HOUSE NUMBER*

STREET ADDRESS*

SUBURB*

STATE/TERRITORY*

COUNTRY*

ZIP/POSTAL CODE*

PHONE NUMBER*

4. EMERGENCY CONTACT

FIRST NAME*

LAST NAME*

RELATIONSHIP TO YOU

EMAIL*

MOBILE

HOUSE NUMBER*

STREET ADDRESS*

SUBURB*

STATE/TERRITORY*

COUNTRY*

ZIP/POSTAL CODE*

IS YOUR EMERGENCY CONTACT IN AUSTRALIA?
YesNo

5. PASSPORT AND VISA DETAILS

DO YOU CURRENTLY HOLD A VALID AUSTRALIAN VISA?*
YesNo

YOUR NATIONALITY*

COUNTRY OF BIRTH*

PASSPORT NUMBER*

PASSPORT EXPIRY DATE*

ARE YOU OF ABORIGINAL OR TORRES STRAIT ISLANDER ORIGIN?*
NOYES, ABORIGINALYES, TORRES STRAIT ISLANDER

SUBMIT COPY OF YOUR PASSPORT DOCUMENTS

6. Disability Status

7. ENGLISH LANGUAGE PROFICIENCY

ASSESSMENT TYPE*
IeltsPteToeflOthers (Please Specify)

SCORE(Individual & Overall Scores)*

DATE ACHIEVED*

UPLOAD ENGLISH RESULTS

8. EDUCATIONAL AND PROFESSIONAL BACKGROUND

HIGHEST QUALIFICATION COMPLETED

COMPLETED IN*

IS THE HIGHEST QUALIFICATION YOU HOLD HIGHER THAN THE COURSE/S YOU ARE APPLYING FOR?*
YesNo

IF YES, BRIEFLY EXPLAIN THE REASON FOR YOUR APPLICATION *

9. Study Reason

OF THE FOLLOWING CATEGORIES, WHICH BEST DESCRIBES YOUR MAIN REASON FOR UNDERTAKING THIS COURSES/?*

10. Employment

OF THE FOLLOWING CATEGORIES, WHICH BEST DESCRIBES YOUR CURRENT EMPLOYMENT STATUS?*

11. Course Information

WHICH COURSES/WOULD YOU LIKE TO STUDY?

INTAKE / MONTH / YEAR*

START DATE*

Visit the St Mary’s Institute Pty Ltd course page for further information regarding intake dates, prices, and courses. Please note SMI cannot guarantee the availability of all selected schedules.

SMI CAN’T GUARANTEE THE AVAILABILITY OF YOUR SLECETED SCHEDULE.

12. How did you hear about SMI?

Other (please specify)*

13. APPLICATION CHECKLIST

COMPLETE ALL SECTIONS OF THE APPLICATION FORMATTACHED EVIDENCE FOR CREDIT OR EXEMPTIONPROVIDE DETAILS IF YOU ALREADY HAVE STUDENT VISA AND/OR OHSCPASSPORT BIODATA PAGEACADEMIC RECORD/QUALIFICATIONSENGLISH TEST RESULTS

14. Student Signature

I CONFIRM THAT*I HAVE READ AND UNDERSTOOD THE SMI'S ENROLMENT TERMS AND CONDITIONS AND REFUND POLICY, AND I FURTHER AGREE TO BE BOUND BY THEM.

FULL NAME OF THE PERSON WHO MADE THE DECLARATION*