Student Enrolment — Fusion English College

Application Type

Application Type *

Course Details

Course Type *

Personal Details

Title

Given Name *

Middle Name

Family Name *

Date of Birth *

Birthplace

Email *

Country of Birth

Nationality *

Passport Number *

Passport Expiry Date *

Do you hold a current Australian Visa?

Visa Type

Visa Number

Visa Expiry Date

Gender *

Contact - In Australia

Unit/Street Number (Australia)

Street Name (Australia)

City/Town/Suburb (Australia)

State (Australia)

Post Code (Australia)

Home Phone (Australia)

Work Phone (Australia)

Mobile Phone (Australia)

Contact - Home Country

Unit/Street Number (Home Country)

Street Name (Home Country)

City/Town/Suburb (Home Country)

State (Home Country)

Post Code (Home Country)

Home Phone (Home Country)

Work Phone (Home Country)

Mobile Phone (Home Country)

Language & Culture

In which country were you born?

Are you of Aboriginal or Torres Strait Islander origin?

Do you speak a language other than English at home?

Other Language

Schooling

What is your highest COMPLETED school level? *

Year Completed

Are you still enrolled in secondary or senior secondary education?

Previous Qualification

Have you successfully completed any qualifications?

Year Completed

Qualification Type

Education Agent

Are you using an education agent?

Agency Name

Contact Person

Contact Number

Email

Employment

Current Employment Status

Study Reason

Main reason for undertaking this course *

Student Declaration

I declare that the information provided is true and correct *

I agree to the collection, use and disclosure of my personal information as per the privacy notice *

Disability Supplement

Do you have any disability, impairment or long-term condition?

Documents

Passport Copy *

High School Certificate

Proof of English Language Proficiency