1. Complete all sections using BLOCK LETTERS
2. Attach verified and attested supporting documents and a copy of your passport 3. Send your application to: Kangan Institute International
Pearcedale Parade Broadmeadows Victoria 3047 Postal: Private Bag 299, Somerton Victoria 3062, Australia
Tel: + 61 1300 175 176 Fax: + 61 3 9279 2623 E-mail: [email protected] Web: www.kangan.edu.au/international
Applicant details
Family name (as shown in passport) Given names
Date of birth (DD/MM/YY) Male Female
Passport number Do you have a disability? Yes No Country of birth Nationality / Citizenship (as shown on passport)
If you are currently living outside Australia, please provide your overseas address. If you are already living in Australia, please provide your Australian address
Number and street
Suburb/town/country Postcode
Home phone number Mobile phone
Email address Skype ID
passport and visa details (Please attach a copy of your passport and visa if applicable) Passport number Passport expiry Are you currently in Australia? Yes No If NO, what type of visa will you be applying for?
If YES, what is the Type of Visa? Visa subclass Visa expiry date Do you have relatives living in Australia? Yes No If yes, provide details:
Have you had an Australian visa refused or cancelled previously? Yes No If YES, reason:
Which immigration office will you be submitting your visa application?
Overseas student Health Cover (OsHC)
Do you have current Overseas Student Health Cover (OSHC)? Yes No If yes, what is your membership number? OSHC expiry date If you would like Kangan Institute to arrange your OSHC, what type of OSHC will you require?
Single (Student only) Multi family (student plus spouse or children) Dual family (Student plus spouse or children) Which immigration office will you be submitting your visa application?
Course preferences
Have you previously been enrolled at Kangan Institute? Yes No If YES, please provide student number
English language course Number of weeks Intake date
Name of course CRICOS Code
1 2
Semester/intake February July Year
How will your studies be funded? Self-funded Private sponsor AusAID /Endeavour Home government Other Do you intend to apply for a university pathway? Yes No
If yes, name of institution Program
english language level (provide details and documentation confirming your English language level)
I have taken a recognised English language test in the last two years (e.g. IELTS, TOFEL, Pearson, Cambridge)
Name of test Score Date of test
Disclaimer
All material presented is distributed by Kangan Institute as an information source only. Kangan Institute makes no statements, representations, or warranties about the accuracy or completeness of any information contained in this publication. The State of Victoria disclaims all responsibility and all liability (including without limitation, liability in negligence) for all expenses, losses, damages and costs you might incur as a result of the information being inaccurate or incomplete in any way, and for any reason.
privacy statement
Personal information collected as a result of your enrolment will be used by the Department for general student administration, vocational education and training administration and regulation, as well as departmental planning, reporting, communication, research, evaluation, auditing and marketing. Only authorised departmental officers have access to this information
• Students are aware that their persona information may be shared between Kangan Institute and the Australian Government and designated authorities as per the ESOS Act 2000 and The National Code 2007. This information includes, but is not limited to, personal and contact details, course enrolment details ad changes, circumstances of any suspected breach by the student of student visa conditions.
• Students agree that Kangan Institute may use the email address supplied by the student as a point of contact for any information the Institute deems necessary.
• Students agree that Kangan Institute will access Visa Entitlement Verification Online (VEVO) services at any time to confirm their visa status, work and study rights.
• Students agree that Kangan Institute will release information pertaining to their enrolment (excluding academic records), attendance and account details to their education agent.
• Student’s personal information will not be disclosed to any other third party without their consent, unless authorized or required by law.
Academic record
If you hold a current student visa, please provide copies of ALL your Confirmation of enrolment (Coe) relating to your visa subclass and complete the details below.
Name of course Institution Date of completion List details of your previous education and attach documentation including certified copies of full academic transcripts.
DOCUMENTS NOT IN ENGLISH MUST BE ACCOMPANIED BY CERTIFIED TRANSLATIONS.
Name of qualifications Institution Country Year finished
employment background
Summary of relevant work experience (certified documentary evidence required)
statement of purpose
Please provide a brief statement outlining your reasons for studying this course at Kangan Institute and in Australia, as well as how you believe this course will contribute towards your chosen career path after you return to your home country (please attach any additional pages if required).
Agent details (Ccomplete this section if you are using an education agent or representative) Agent name
Agent address
Agent telephone Agent email part 1: Declaration by applicant
I certify that the information provided on this application form is accurate and complete. I authorise Kangan Institute to obtain other details relating to my academic record as necessary.
I declare that I am aware of and understand my financial obligations relating to studying in Australia and with Kangan Institute. I certify that I have access to the total funds required whilst in Australia to cover all costs associated with my study.
I acknowledge the provision of incorrect information or documentation, or the withholding of information or documentation relating to my Application may result the cancellation of my enrolment and the forfeiture of any tuition fees paid.
Signed: Name: Date:
part 2: Declaration by parent or guardian (if student is under 18 years of age)
I have read the information provided on this Application and certify that the details are accurate and complete. I hereby apply for the entry of my child/ward to study with Kangan Institute in Australia.
I declare that I am aware of and understand my financial obligations relating to my child/ward study in Australia and with Kangan Institute. I certify that I have access to the total funds required whilst in Australia to cover all costs associated with my child/ward study.
I acknowledge that the provision of incorrect information or documentation, or the withholding of information or documentation relating to my child/ward’s Application may result in the cancellation of my child/ward enrolment and the forfeiture of any tuition fees paid.
Signed: Name: Relationship: Date:
Applicant checklist
Completed all sections of the application form Read and understood the terms and conditions and refund policy Attached certified copies of academic qualifications Provided evidence of English language ability (if required) Attached a certified copy of passport and visa Any relevant employment documentation (if required)
KANGAN BATMAN INSTITUTE OF TAFE trading as Kangan Institute STREET ADDRESS
Kangan Institute International Pearcedale Parade
Broadmeadows Victoria 3047 AUSTRALIA
POSTAL ADDRESS
Kangan Institute International Services Private Bag 299
Somerton Victoria 3062 AUSTRALIA
Telephone: + 61 1300 175 176 Facsimile: +61 3 9279 2623
Applications and enrolments: [email protected] Website: kangan.edu.au/international
CRICOS Provider Code: 01218G
For more information contact Kangan Institute International Services or your local authorised representative.
YOUR LOCAL REPRESENTATIVE
INSTITUTE REGISTRATION
Kangan Batman Institute of TAFE trading as Kangan Institute is a Registered Training Organisation (National Code 0306) under the Australian Training Quality Framework (AQTF).
The Institute is also governed by the Victorian Government’s Vocational Training Act 1990 and is government owned.
Kangan Batman Institute of TAFE Provider Code on the Commonwealth Register of Institutions and Courses for Overseas Students (CRICOS) is 01218G. The Institute operates in compliance with the Education Services for Overseas Students Act 2000 (ESOS).
The information was correct at time of printing (February 2014).