Enrolment Form

Business and Management BSB50420 Diploma of Leadership and ManagementBSB60420 Advanced Diploma of Leadership and Management

Intake Month * —Please choose an option—JanFebMarchAprilMayJuneJulyAugSepOctNovDec

Intake Year * —Please choose an option—202520262027202820292030

Applying visa from * —Please choose an option—Onshore (in Australia)Offshore (Overseas)

Are you applying for RPL or Credit Transfer? YesNoMaybe

Date of Birth *

Home phone

What is the address of your usual residence?
Please provide the physical address (street number and name not post office box) where you usually reside rather than any temporary address at which you reside for training, work or other purposes before returning to your home. If you are from a rural area use the address from your state's or territory's 'rural property addressing' or 'numbering' system as your residential street address. Building/property name is the official place name or common usage name for an address site, including the name of a building, Aboriginal community, homestead, building complex, agricultural property, park or unbounded address site.

What is your postal address? (if different from above)

Passport Number *

Expiry Date *

Country of Passport *

What type of visa are you currently holding (if currently holding a visa)
If currently enrolled with any other education provider, please provide a copy of your current student visa and all eCoEs that you are holding with your application *

Visa Expiry Date *

If you indicated the presence of a disability, impairment or long-term condition, please select the area(s) in the following list:
You may indicate more than one area) Please refer to the Disability supplement at the back of this form for an explanation of the following disabilities

Highest Academic Qualification Completed

What is your highest COMPLETED school level
If you are currently enrolled in secondary education, the Highest school level completed refers to the highest school level you have actually completed and not the level you are currently undertaking. For example, if you are currently in Year 10 the Highest school level completed is Year 9. * —Please choose an option—Year 12 or equivalentYear 11 or equivalentYear 10 or equivalentYear 9 or equivalentYear 8 or belowNever attended school

Other information(if applicable)

Certificate I or Certificate II —Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Advanced Diploma/Associate Degree —Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Certificate III —Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Bachelor Degree —Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Certificate IV —Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Graduate Certificate/Graduate Diploma —Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Diploma —Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Masters Degree or higher —Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Year 12 or equivalent —Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Name *

Relationship to you *

Address *

Home Phone

Work Phone

Mobile Phone *

Email *

Company name

Contact person

Phone

Email

Documents

Proof of English Language Proficiency

Copy of your passport *

Copy of your visa (if you are currently in Australia or have a valid one) *

Copies of your highest qualification (overseas and in Australia)

Any other documents to support your application

If applying for a USI additional copies of support documents as outlined in the USI section of the application.

Any current or previous CoEs held in Australia.

A release letter from your current education provider, current and future COEs from current provider (if applicable and applying for transfer of providers)

I declare that the information I have provided to the best of my knowledge is true and correct.

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I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above.

Signature *