Application Form File no:

For admission as an international student Tag:

SECTION 1 NAME AND CONTACT INFORMATION
Family Name: Date of How to apply
birth 1. Complete this form in
day month year BLOCK letters using a black
Given Names:
Male Female or blue pen.
Address in Number & street name City/suburb
2. Attach the A$70
Home Country: application fee. See back of
form for payment methods.
State Postcode Country
Your application will not be
processed without this fee.
Area code Tel Fax
Exemptions:
> English only programs
Email
> Current or returning RMIT
students
Mailing Address Number & street name City/suburb > Year 12 students applying
(if different from through VTAC
above): State Postcode Country > Research and PhD
programs
Area code Tel Fax 3. Attach one certified copy
(do not include originals) of
supporting documents (refer
SECTION 2 RESIDENCY AND OTHER INFORMATION to list on back of form).
4. Return completed form to
Country of Birth: Citizenship Passport no. RMIT International (see
address below) or to your
Visa Type: Student Visitor Other (specify type and category no.) RMIT accredited agent.

Residency: Are you currently in Australia Yes No Are you a permanent resident of Australia? Yes No
Which country are you applying from?

Medibank Medibank no. Expiry date

(if applicable)::
Agents: Are you applying through an RMIT agent? Yes No Agent’s name

Scholarships and Have you applied for a scholarship? Yes No Scholarship provider
Sponsorships: If yes, please provide letter from your scholarship provider. Agent’s stamp
Are you being sponsored by your employer? Yes No Employer name
Exemptions: Are you applying for exemptions? Yes No If yes, please provide a syllabus

SECTION 3 ENGLISH LANGUAGE PROFICIENCY

English Ability: Is English your first language? Yes No
Have you studied at secondary or post secondary level with English as the medium of instruction? Yes No
If yes, please provide evidence.
English Studies: Are you planning to enrol or are you enrolled in English Language Studies? Yes No
Date of program Level Institution Where to submit
completion
your application
English Test Score Have you taken an English test in the last 6 months? Yes No If no, do you plan to take a test? Yes No RMIT International Pty Ltd
(IELTS or TOEFL):
Test date Test name Result Postal Address:
GPO Box 2303U
If not known, please submit Melbourne, Victoria 3001
SECTION 4 APPLICATION INFORMATION results as soon as possible. Australia

RMIT Pathway Complete to apply for a pathway (eg VCE, year 11, foundation studies) leading into a higher award: Street Address:
Program/CRICOS code Name of program Intake Date Level 4, 239 Bourke Street
Melbourne, Victoria 3000
Australia

RMIT Program Complete in order of preference to apply for an RMIT program (eg diploma, degree, postgraduate): Tel: +(61 3) 9925 5156
Program/CRICOS code Name of program Intake Date Fax: +(61 3) 9663 6925
Email: isu@rmit.edu.au
www.international.rmit.edu.au

OFFICE USE ONLY

Interviewed by:

Date:
English Program English Only (tick here):
Start Date Form submitted at:
Only Tick the type of program and number of weeks: Exhibition/Interview
General English for English for English for English for English for English for English for Total weeks
English Academic Science & Tourism and Business* Teaching* Aviation* Art & Design* of English SIC
weeks Purposes* Technology* Hospitality* 10 weeks 10 weeks 10 weeks 10 weeks Agent office visit
(up to 40 weeks) 10 weeks 10 weeks 10 weeks 20 weeks
Date of Issue: Jan 2003
*These programs are available at certain levels, check the REW/CELL brochure for details. Programs will run subject to class numbers.
RMIT University CRICOS
English Program English as part of a pathway to RMIT TAFE or University (tick here): Provider Code 00122A. Centre
as a Pathway for English Language
In the boxes directly above, tick the type of program preferred. RMIT will advise the number of weeks required Learning CRICOS Provider
depending on your English language proficiency level. Code 01912G
 SECTION 5
1. Current Studies:
2. Secondary School
Studies:
3. Post Secondary
(Tertiary) Studies
(eg degree, diploma):
4. Employment
History
Please list full details
and attach a separate
page if necessary:
SECTION 6
SECTION 7
Application fee
payment
A non-refundable
application fee of A$70
must be submitted with this
application. These payment
methods are accepted:
QUALIFICATIONS AND WORK EXPERIENCE
Are you currently studying? Yes No (if no, go to 2.)
If yes, indicate the date your results will be available
Will you complete this program before commencing your new program at RMIT? Yes No
List your current program of study:
Years enrolled Country Institution Name of qualification
From To
List details of the secondary studies you have completed:
Years enrolled Country Institution Name of qualification
From To
From To
List details of the post secondary studies you have completed (if applicable):
Years enrolled Country Institution Name of qualification
From To
From To
From To
List your employment history (if applicable):
Date of employment Position and duties Employer
From To
From To
From To
SPECIAL CIRCUMSTANCES
If you have any disability which may affect your learning (eg vision impairment, health, mobility) you should
provide early advice so that the University may assist you. Please attach additional information on a separate
sheet if required.
ATTACHMENTS AND DECLARATION
The following items must be included when you submit your application. Please refer to the Faculty brochures for details.
(applications which are submitted without necessary attachments will be delayed in processing).
Compulsory Attachments Submit these attachments if applicable:
Certified academic transcripts Portfolio Research proposal
Evidence of English proficiency References from employers English translations
Personal statement Letter from scholarship provider
Graduation certificates
CV (resume) Application fee
I declare that to the best of my knowledge the information supplied in this application and the documentation support is correct and complete. I acknowledge
that the withholding of, or provision of incorrect, documentation relating to my application may result in cancellation of any offer or enrolment by RMIT
University. I understand that RMIT University reserves the right to discontinue or alter any program, course/subject, fee, admission requirement, staffing or other
arrangement without prior notice. Under the ESOS Act 2000, National Code 51, personal information you provide may be made available to Commonwealth
and State agencies and the ESOS Assurance Fund.
Have you completed all sections of the application form and read the declaration? Yes No
Applicant’s signature: Date:
Online Credit card Telegraphic transfer
Pay by Visa or Master Card credit card Visa or Master Card. Please complete details below: Paid in accordance with the following details:
through our secure website: Name on credit card Payee: RMIT University
www.international.rmit.edu.au Bank: Commonwealth Bacnk of Australia
Branch: 255 Bourke Street, Melbourne,
Bank draft Card number Australia 3000
Draft should be payable to ‘RMIT A/C no: 1ooo 6849
University’ in Australian dollars and to an BSB no: 063-262
Australian bank. Write your student Expiry Date
number on the back of the draft. A copy of the telegraphic transfer, inluding your
full name and contact details, must also be
faxed to RMIT International Pty Ltd.