Application form


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Application form

Australian Students Please print in BLOCK LETTERS

Personal details Title:

Mr Ms

Program selection Mrs

Miss

Pre-university (Certificate) program Certificate IV in Tertiary Preparation Program (TPP)

Other

Family name: Given names: Preferred name: Date of birth: DAY / MONTH / YEAR

Gender:

Male

Female

Contact details

SAIBT program commencement Please indicate the year and semester in which you wish to begin your studies.

Applicant’s contact details

Year

Address:

Tel (home): Email: Country of birth: Nationality:

No Are you a citizen or permanent resident of Australia? Yes Please note that you will have to provide evidence of citizenship or residency at or before enrolment (eg a certificed copy of your birth certificate, passport, citizenship certificate or visa).

Education details Secondary Education—highest level achieved Name of qualification (eg SACE Stage 2, other Year 12): School attended: Country/state: Year completed:

Name of qualification (eg degree, diploma, STAT test): Institution attended: Country/state: Yes

No

Year completed:

Please attached certified copies of all academic transcripts or mark sheets. Will you be applying for exemptions (recognition of prior learning)? Yes No If so, provide copies of relevant academic transcripts and a completed Application for Credit form (visit saibt.sa.edu.au for details).

Employment history

Request for disability support

completed all sections of the Application form attached certified copies of your academic qualifications* included relevant employment documentation (if required) included a copy of your birth certificate or passport * A certified copy is signed by an authorised officer to acknowledge that it matches the original document exactly. Authorised officers include: • staff of the SAIBT office in Adelaide • staff of the institution that issued the document • a Justice of the Peace or Public Notary • staff of an Australian Embassy, Consulate or High Commission

I declare the information I have supplied on this form is, to the best of my understanding and belief, complete and correct. I understand that giving false or incomplete information may lead to my application being refused or my enrolment cancelled. I have read and understood the relevant program information in this brochure and/or on the SAIBT website and I have sufficient information about SAIBT to enrol. I understand that the pathway may lead to future studies at the University of South Australia, subject to the University of South Australia’s entry requirements. I give permission for SAIBT and the University of South Australia to obtain official records from an educational institution attended by me, and to supply my contact details and any relevant official records to educational institutions I am eligible to gain admission to. I understand that the fees quoted may be subject to increase. I understand that any conditions concerning an offer of admission will be contained in my letter of offer from SAIBT, which I will be required to read and sign.

Applicant’s signature:

DAY / MONTH / YEAR

If you are under 18 years of age, your parent or guardian must also sign this application form.

Parent’s/guardian’s signature: Yes

No

If ‘yes’, please specify: Hearing Vision Mobility Medical Learning Other (please specify): Please attach relevant information so that SAIBT and the University of South Australia can arrange assistance if possible.

SAIBT CRICOS provider code: 02193C University of South Australia CRICOS provider code: 00121B

Check that you have:

Date:

If you believe you have employment experience relevant to the program you are applying for, please attach a CV and references.

Do you have a disability that may affect your studies?

Application checklist

Declaration

Tertiary and further education—highest level achieved

Completed:

October

UniSA Letter from UniSA UniSA Open Day School Careers Counsellor The Advertiser Facebook Television Radio Recommended by a friend/relative — if so, is your friend/relative a SAIBT student? Yes No Other, please specify:

Mobile:

No

June

How did you first learn about SAIBT? You may tick more than one.

Tel (work):

Yes

February

Other information

Postcode:

Completed:

University-level (Diploma) program Diploma of Arts Diploma of Business Diploma of Technology (Information Technology) Diploma of Technology (Engineering and Environment) Associate Degree in Management

Date:

DAY / MONTH / YEAR

Postal address for applications Admissions Office South Australian Institute of Business and Technology GPO Box 2471 Adelaide SA 5001 Australia T +61 8 8302 2021 E [email protected]

F +61 8 8302 1557 W saibt.sa.edu.au