5STAR Student Services

The purpose of this form is to collect the information required to commence the application process for enrolment in your chosen course. You do not pay any fee until you have accepted your formal offer of enrolment from the Education Provider and you can obtain a refund up until the course commencement date. For further details, please do not hesitate to contact the Enrolments Officer at 5STAR Student Services via email applications@5starss.com. Also please refer to www.5Starss.com for additional information. Documents requested should be scanned as a pdf and forwarded via email or sent by registered post.

How did you hear about us? (please choose from the following)

Friend/Family
Educational Exhibition
Education Agent
Website
Advertisement

1. PERSONAL DETAILS (please click to enter & type response beside prompt)

Title (Mr/Mrs/Ms): Family Name: Given Names: Preferred Name: Date of Birth (dd/mm/yyyy): Age (in years):

Gender (please select)

Male
Female

Contact Details - Home Country (please type response beside prompt)

Address: Phone: Email:

Contact Details -Australia (please type response beside prompt)

Address: Phone: Email:

Do you have any disabilities or special learning needs that will affect your study?

No
Yes

2. PASSPORT AND VISA DETAILS

Country of Citizenship (as shown on passport): Country of Birth: Passport Number (please forward a clear certified copy of your passport photo) : Do you hold a current Australian Visa (Yes or No?): If Yes -please specify Subclass number: In which city will you apply for your student visa? Will there be dependents on your student visa application? Yes or No

If your Dependants are travelling with you please supply details

Dependent 1 Given Name: Family Name: Relationship: Date of Birth: Dependent 2 Given Name: Family Name: Relationship: Date of Birth: Dependent 3 Given Name: Family Name: Relationship: Date of Birth:

3. OVERSEAS STUDENT HEALTH COVER (OSHC)

Do you want 5STAR Student Services to arrange Overseas Student Health Cover?

No
Yes - Single Cover
Yes - Family Cover

4. COURSES AND EDUCATIONAL PROVIDERS

Details of course/s applications:

1. School/College/University: Course: Campus: Intake: 2. School/College/University: Course: Campus: Intake: 3.School/College/University: Course: Campus: Intake:

5. ENGLISH LANGUAGE

Is your first language English?

No - please forward copies of your English results (i.e. IELTS)
Yes

6. EDUCATION HISTORY

Please list the details of past education and training including highest levels reached. (please forward certified copies including highest levels reached).

1. Year: School/College/University: Country: Name of Qualification: Course Duration: Language of Instruction: 2. Year: School/College/University: Country: Name of Qualification: Course Duration: Language of Instruction: 3. Year: School/College/University: Country: Name of Qualification: Course Duration: Language of Instruction:

Do you want to apply for credit transfer or RPL (Recognition of Prior Learning or academic credit for studies previously undertaken in Australia?

Yes
No

7. PREVIOUS/CURRENT AUSTRALIAN STUDY DETAILS (if applicable)

Are you currently studying with another region or college in Australia?

No
Yes - please specify Region/College

If YES, do you have a Letter of Release?

No
Yes - please forward a certified copy

8. TRANSPORT AND ACCOMMODATION OPTIONS

If you would like further information on transport and accommodation options (please tick the relevant boxes)

Transport options from Brisbane Airport
Accommodation options

9. SCHOLARSHIP DETAILS

Are you applying for a scholarship?

No
Yes – If YES, please specify who is offering the scholarship

Click to enter text

10. DECLARATION

I certify that the information on this form and the supporting documentation are correct and complete. I authorise 5STAR Student Services to obtain other details relating to my academic records. I acknowledge that the provision of incorrect information or documentation relating to my application may result in the cancellation of my enrolment. I further acknowledge that the Education Provider may make available this information to Australian Commonwealth and State Agencies and the Fund Manager of the ESOS Assurance Fund, pursuant to obligations under the ESOS Act 2000 and Standard 3 of the National Code.

Signature

Date

Privacy Disclaimer- 5 STAR Student Services is collecting your personal information in accordance with Standard 2 of the National Code 2007 in order to process student applications. The information will only be accessed by authorised employees of 5STAR Student Services and the relevant Education Providers to whom you are applying. Some of the information may be given to the Department of Education, Training and Employment and the Department of Immigration and Citizenship for reporting purposes. Your information will be also be stored on Yolasite Secure Servers in the USA. Your information will not be given to any agency unless you have given us written permission or we are required by law to provide this information.

11. SUBMISSION

Please list the documents (tick the relevant boxes) you have forwarded as part of this application.

Copy of Passport
Copy of Visa (if in Australia)
Copy of English language test results (if applicable)
Copy of the Qualification listed in the Education History Section
Copy of Overseas Student Health Cover (if applicable)

Please submit the Student Enrolment Form and all supporting documents directly to:

Mail: PO Box 415, The Gap Queensland 4061 Australia Phone +61 7 33005178 Fax +61 7 33005180 Email: applications@5starss.com