CTORIAN

Victorian Institute of Technology Pty Ltd

.
NSTITUTE OF
ECHNOLOGY
ABN : 41 085 128 525 RTO No: 20829 TEO SA ID: PRV14007 CAICOS Provid er Code: 02044E

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STUDENT APPLICATION FORM {INTERNATIONAL) - Higher Education
(Applicant shall be 18 years of age as of course commencement date)
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PERSONAL DETAILS

Titl e ifMr 0 Miss 0 Ms 0 Other _ _

Legal Last Name
Legal First Nam e ~I r£SYf (Surnam e) L-r:JrVLll
Gender . 0 Male 0 Female Date of Birth 27 I /)eC I J,.000
CONTACT DETAILS
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Building/ Prop erty
Flat /Unit Number
Name

Street Number Street Name

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Suburb/ Town Stat e
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Country Post Code
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Mobile Phone (Hom e)
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Fax Phone (Wo rk)

E-mail
TTV/U71<£T 2-.9 @ 07/Ylr:JC L lof'1
IN CASE OF EMERGENCY

Nam e
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Relationship
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Street Number Street Nam e

Suburb State
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Count ry Post Code
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Mobil e Phone
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E-m ail

NATIONALITY/ CITIZENSHIP DETAILS HOW DID YOU HEAR ABOUT VIT?

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National ity (a s indicated on passport) : fl/(_/?IJl £~ £_ D F ~ie nd 0'"Education Agent

Country of Birth : D Advertisement 0 Website

NffJlfL
Passport Number:
11 otv2f/4- D Other (pl ease specify):

Expiry Date of Pass port : 05 S'e.P 2.tJ2J -- - -· - --- -

COURSE/S & CAMPUS YOU WISH TO STUDY AT VIT (Enrolm ent Fee of $200 appli es. Enrolment Fee i s non-r efundable}

Choos e Campus Location M1\ii elbourne Campus D Sydney Campus

Hsach elor of Inform ation Technology & Systems 0 Master of Information Technology and System s
(CR ICOS Course Code : 085:i76A; Course Duration: 156 weeks ) (CRICO S Cou rse Cod e: 096838D; Course Dura ti on: 96 weeks)
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Preferred Course Start Date
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Stuaent Appl1cat1on Forrn (lnt.ernat1onal) ··· H1ghe1 Education I Vers10n; 17 2 I Issue Date: 12 January 2018 I Review Date· °.1 Ju ly 2019
Managed By: Manager Studen t Administra t ion I A ut hori~·,i: CEO I Page 1 of 5
VIT (Victorian Institute of Te chn ology)
Head Office: Leve l 14, 123 Quee n St, Melbo urn e, Victor ia 3000, Au stralia Sydn ey Campu s: Level 5, 333 Kent Street, Sydney, NSW 2000 , Australia
Phone: (61) 1300 17 17 SS Emai l: [email protected]
HOHIAN
NST'TUTE OF Victorian Institute of Technology Pty Ltd
[ ( HNOLOGY
ABN : 41085128 525 RTO No: 20829 TEQSA ID: PRV14007 CAICOS Provider Code: 02044E

RPL / CREDIT TRANSFER /

Do you want to apply for any RPL or Credit Transfer? ~No LJ Yes
{If Yes, Student to complete the "Credit Transfer Application Form")

LANGUAGE AND CULTURAL DIVERSITY

Do you speak a language other than English at home? (If more than one language, please indicate the one that is spoken most often)
0 No M'Ves Iplease specify): __€_f._'fj~[~L_·--------·-·-·---------------
--'N
How well do you SPEAK English? BVery Well 0 Well 0 Not Well 0 Not at All

AIRPORT PICKUP & ACCOMMODATION

OVERSEAS STUDENT HEALTH COVER (OSHC)
SERVICES
It is compulsory for student visa holders to have and maintain Overseas Student Health Cover. Do you need airport pickup? LJ Yes t:J No

Do you want VIT to organise OSHC for you? 0'Yes 0 No

Do you need accommodation r-/

Please specify type of coverage: 0°'Single 0 Couple 0 Family

assistance? 0 Yes '\£:]No
If "Yes". Please indica t e your requi rements
Please specify length of coverage: Q15uration of course/s D One year separately to VIT via e-mail
ENGLISH LANGUAGE PROFICIENCY

0 English is my first language B'!ELTS !Score)~ (attach evidence)

0 Other English test result {Score) _ _ _ _ Iattach evidence)

0 Planning to study English in Australia at a NEAS Accredited Provider I name) _______________________ _

D Completed studies in an English language speaking country, equivalent to an Australian Year 12 qualification or above (attach evidence)
DISABILITY
Do you consider yourself to have a disability, impairment or long-term condition? 0 No 0 Yes
(If Yes, please specify the areas of disability, impairment or long-term condition. You may indicate more than one area. Please attach documentation
describing your disability, impairment or long-term condition in more detail) .

0 Hearing/Deaf D Physical 0 Intellectual 0 Learning 0 Mental Illness

0 Acquired Brain Impairment 0 Vision 0 Medical Condition 0 Other: - - - - - - - - - - -

EMPLOYMENT STATUS
Of the following categories, which BEST describes your current employment status? (Tick ONE box only)

0 Full-time Employee 0 Part-time Employee 0 Self Employed - Not Employing Others

0 Employer 0 Employed - Unpaid Worker in a Family Business 0 Unemployed - Seeking Full-time Work

0 Unemployed - Seeking Part-time Work ffiot Employed - Not Seeking

SCHOOLING
Are you still attending secondary school? 0"'Na 0Yes What is your Highest COMPLETED school level? {Tick ONE box only)

19"Completed Year 12 0 Comp I eted Year 11 0 Completed Year 10 0 Completed Year 9 or Equivalent

0 Completed Year 8 or Lower 0 Did Not Go to High School

In which YEAR did you complete the above school level? _f,P__JjJ_____ State:

Name of school: n yfo fZ-0 5 £ co rvO lfP.. y ( U1 ov l Country: fl/t£fJf/-L

PREVIOUS QUALIFICATION(S) ACHIEVED
Have you successfully completed any of the following Qual ifications? ~o 0 Yes {Tick any applicable boxes)

0 Bachelor Degree or Higher Degree 0 Associate Degree 0 Advanced Diploma

0 Diploma or Associate Diploma 0 Certificate IV or Advanced 0 Certificate, Technician

0 Certificate Ill or Trade Certificate 0 Certificate II D Certificate I 0 Certificates Other Than the Above

STUDY REASON
Of the following categories, which BEST describes your main reason for undertaking this course? (Tick ONE box only)

D To get a job 0 To develop my existing business D To start my own business

0 To get a better job or promotion 0 It was a requirement of my job 0 I wanted extra skills for my job

0 To get into another course rA study Qfor personal interest or self-development 0 To try for a different career

0 Other Reasons (please s p e c i f y ) : - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - -- - - - - -

Student Application Form (lnternation~I) - H1ghPr Education I V'"""'" 17 2 I Issue Date· 12 Januory 2018 I Review Date· OJ July 1019
Managed By: Manager Student Administration I
Authom ed.Jl.~y:_C_E_O_ _ _ __ _~l_______P_a~g~e_2_o_r_s_,
VIT (Victorian Institute of Techno logy)
Head Office: Level 14, 123 Queen St , Melbourne, Victor ia 3000, Au stralia Sydney Campus: Level S, 333 Kent Street, Syd ney, NSW 2000, Austra lia
Phone : (61) 1300 17 17 SS Email : info@v1t edu au
i lCTORIAN
NSTITUTE OF Victorian Institute of Technology Pty Ltd
' EC.HNOLOGY
AB N: 410851 28 52 5 RTO No: 20829 TEOS A ID: PRV 14007 C AICOS Provider Code: 02044E

Financial Costs

Do you understand the costs associated with studying in Australia? .f'.rYes D No

(including the course fee , living expenses, OSHC, return airfares etc .) '
Complete the Annual Living Cost table below for yourself and any dependents who may accompany you as proof th at you understand th e costs
associated with study In Australia.
Dependents
Annual Expenses$ (AUD) Self Total
Spouse Children
Course Fees 'b ,ooo
Living Expenses
?J!J I 29 0
OSHC f j,OO
Schooling for children

Return Air Fare fOO O

Total 1 909 D
How will you fund your studies and living expenses?
D Self-Fund ed Q"P rivate Sponsor i;;;:rsank Loan D Governm ent / Employer / In stitution Spon so r D Oth er
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VISA Information

Have you previously visited or studied in Australia? 0YesBNo If YES, VISA type :
Have you previously breached any visa conditions? D Yes !;J-No If YES, please provid e details: - - - - - - - - - - - -
Have you ever been refu sed a visa for entry into Australia or a country other than Australia? D Yes 0 'No
If YES, pl ease provide details :
Have you ever been convicted of a crime or offence ? D YesM'No If YES, please provide detail s : - - - - - - - - - - - - -

REFUND POLICY (INTERNATIONAL STUDENTS)

1. Refund due to Student Default
1.1 Visa Refusal:
a. If Students was refused a stude nt visa and the refusa l was a r eason for the student's failure to start the course on the agreed starting day for the course, or
withdrawing from t he course on or before the agreed st art ing date, course fee (tuit ion fee and the non-tuition fee) minus th e lesser of the fol lowing will be
refunded.
a. 5% of the amount of course fees received by the provider in respect of the student before the default date
b. AU $500.00
b. If a student was refused a student visa after the student commenced the course and t hat refusal has resu lted in either the student withdrawing from the
course or the student failing to pay an amount that he/ she is liable to pay VIT to undertake the course, tuition fee for the weeks in default period (unspent
tuition fees) will be refunded. Non tuition fee paid will not be re funded.
Refund amoun t = weekly tu ition fee x weeks 1n defaul t period
1.2 Prior to Commencement (Other than visa refusa l)
a. If written notice of withdrawal is r eceived from a studen t more t han 60 days prior to the initial course commencement, total tuition fee less AU $500.00 is
refundable . Non tuit ion fee is not r efundab le.
b. If written notice of withdrawal is rece ived from a student less than 60 days but more than 28 days prior to the initial course commencement, 50% of the
tuition fees 1s refundable. Non tuition fee is not refundable.
c If written notice of withdrawal 1s received from students less than 28 days prior to commencement of course date or failed to commence the course on an
agreed commencement date, no refund wi!I be issued.
d. If students defer course commencement date and then apply for a refund no refund will be iss ued .
1.3 Post commencement (Other than vi sa refusal)

..
Under following circumstances, no refund w ill be issued to students.
Students cancel their enrolment in a course after thei r comme ncemen t date (this includes abandonment of course enrolled in before its completion)

. In the event t hat studen t s seek and are gr anted approval by VI T to t ra nsfer to anot her provider prior to completion of six months st udy of t he principal course
In the even t t hat the students enrolment 1s cancelled because of infringement wit h Vict orian Institute of Technology' D1sc1pl1nary Policy or breach of student
visa conditions or fail to make scheduled payment of their fees and charges
1.4 If there is no wri tt en refund ag r eem ent
If VI T did n't enter into a writ ten re fund agreement w ith st udent, VI T will re fund th e unspent tu ition fees t o the student. The refund amount w ill be calculated as
below
Refund amou nt= weekly t uit ion fee x weeks in default period
2. Refund due to Provider Default

..
Provider Defau lt occurs in the follow ing circumstances:
The course does not commence at the location on the agreed commencement da t e (or)

. The course ceases t o be provided at any time aft er it commences but before it is complet ed (or)
If a sanct ion has been imposed and VIT was preven t ed from provid ing the course
In the case of a Provid er Default, VI T discharge it s obligation t o the st uden t s within 14 days from the day of the default. Student will be given the following option to

.
choose from .
Receive a refund of tuit ion fees for t he weeks in default period (unspent tuition fees)

. Refund amount= weekly tu1t1on fees x weeks 1n default period

Receive placement in an alterna t ive course with VIT or another provider at the provider's expense If students choose this option, students must accept the
offer 1n wri t ing. All the unspent tuit ion fees will be transferred to the new course

Student Application Form (International) - Higher· Education I Version: 17 2 I Issue Date: 12 January 2018 I Review Date 01 July 2019
Managed By: Manager Student Adrnin1stration I
Authorize_d Sy: CEO I Page 3 of 5
VIT {Victorian Institute of Tec hnology)
Head Office: Level 14, 123 Queen St, Melbourne, Victoria 3000, Aust ralia Sydney Campus: Level 5, 333 Kent Street, Sydney, NSW 2000, Australia
Phone: (61) 1300 17 17 55 Email: [email protected]
•( TORIAN
NST 1TU TE OF Victorian Institute of Technology Pty Ltd
fCHNOLOCY
ABN: 41085128 525 RTO No: 20829 TEOSA ID: PRV14007 CRICOS Provider Code: 02044E

If VIT fails to discharge its obl1gat1ons (fails to provide a refund or place students in an alternative course), the Tu1t1on Protection Scheme will be responsible for
placing students in a suitable alternative course or refund the unspent tuition fees. More information on Tuition Protec t ion Scheme will be available on
www.tps.gov.au website.
3. Refund of OSHC, Air p ort Pi ckup and Acc ommod ation charges
'
If students' refund application has been approved prior to course commencement, VtT will refu nd t he Overseas Student Health Cover {OS HC) amount pa id by
students to VIT If stude nts have commenced their studies and require a refund of OSHC Student wil l be requir ed to apply to OSHC prov1der directly for
reimbursement of amount paid.
If students refund appltcation has been approved prior to course commencement, VIT will refund any amount, which has not been paid to accommodation
provider, Accommodation Placement Fee and Airport Pickup. In other circumstances, where the money have been paid for, students are required to apply
directly to the accommodation provide r and Airpo rt Pickup service providers for a refund.
Vil does no t..t. ake responsibility and is not liable for the refu nd policies of t hose service providers.
4. Applying for a refund
To apply for a refund students must complete the Refund Appl1cat1on For'Tl and attach any evidence or documentation relevant to the refund appl icat ion
Students must submit the form to Admissions for refu nds prior to arrival/commencement; or Student Services for refunds after commencement
Students will be not1f1ed of the outcome of their refund application 1n writing and paid any refund calculated as per the policy within 10 working days of the
receipt of the Refund Application For m.
Note:
If students are dissatisfied with the outcome of their refund application , he/she can lodge an appeal under the VIT's Complaints and Appeals Pol icy To request the
Complaints and Appeals Policy, please email [email protected]
5. The Refund Policy and the Complaints and Appeals Policy does not remove t he right for a student to take further action under Australia's Consumer Protection
Laws.
VISA ENTITLEMENT VERIFICATION ONLINE (VEVO) AUTHORISATION
I authorise VIT to use my personal information to access the VEVO for my enrolment and during my course at VIT to determine my Australian Visa status and Visa
conditions that apply to my visa.

APPLICANT'S DECLARATION and SIGNATURE

I declare that the mformation I supplied on th is form is correct and complete.

2. I have read and understood VIT {Victorian Institute of Technology) current Prospectus and/or relevant information on VIT's website. I have read and
understood VIT's pol1c 1es on "St udent Fees and Refund Policy", "Deferment, Suspension or Cancellation of Study during Enr olment", "Complaints and
Appeals ", "Transfer between registered providers", "Monitoring Course Progress" and other policies that Jre published on the VIT's website and 1n Students
Hand Book.
I understand that Vff reserves the right to d1sconttnue or alter any course , subject, fee, admtsstan requirement , staffing or other arrangement without prior
notice . VIT reserves the right to cancel or not offer a course . If any course is cancelled or not offered VIT will refund all tuition fees in accordance with Vil
refund policy This agreement does not remove the right to take action under Australia's consumer protect 1on laws
I understand that all personal information collected by VIT 1s conf1derit1al and may be made available for the relevan1 Commonwealth and State agencies, VIT
authorized credit collectors and where required by the Law. This information includes personal and contact details, course enrolment details and changes,
academic information and the circumst ance of any suspect ed br each of th e stu d ent visa cond itions.
5. I decl ar e that I am a genuine te m porary ent ran t and genuine stu d en t and that I have read and understood conditions relating to these requirements on
t-, tt ps: //www. ho mea ff airs .gov .a ult rav Is t ud/ more/Genuine-Te m pora ry-E nt rant
6. I am aware of the course fee and living costs of my stay in Australia and have the financial capacity to meet such costs for the durat io f my course. I will
make timely payments o : }e

Appl icant ' s Signature ----t=-~'----------- Parent's / legal Gu ard ia n 's Signatur e
(T his declaration must be signed a Parent or Leg I Guardian
1f the applicant is under 18 years ~ge at the time of application )

Date : Date : .d 0 ~ ;)}

APPLICANT'S CHECK LIST (TICK ALL THAT YOU HAVE COMPLETED)

All details i n the application form is filled correctly Q1'have asses s ed the applic a nt as a Genuin e Te mporary Ent ran t
BApplication i s signed and dated and a Genu i ne Student a s defin e d by the Au str alian D ep artm ent of
Home Aff air s (known as D e p a rtm e nt of Immi g ration a nd Bord e r
~ I attached documents are V erified by agent or Certified Prot e cti o n) .

I am attach i ng he follow i ng document s

Q'Pas sport cop y

0 V i sa copy (if you are already hav i ng a valid Australian Visa)

Q-'A ustralian Year 12 equvalent with mathematics specialisation

bl-1S'r oof of English

D Any othe r Academ i c documents

Certificates/Tran scri pis/Statements of Ata i nme nt

D Any work Ex peri e nc e l e tt e r s

0 Release Lett er if required
PLEASE SUBMIT YOUR APPLICATION TO: VIT (VICTORIAN INSTITUTE OF TECHNOLOGY)
Level 14, 123 Queen St, Melbourne, Victoria 3000, Australia
EMAIL: [email protected] .au
Student Appllcat1on Form {lnr.ernat1onal) Higher Education Vf•r s1on: 17 2 l>Sue Dote: 12 Januory 2018 Review Date 01July2019
Managed By Manag er Studen t Admirnstrat1on Authomcd By CEO Poge 4 of S
VIT (Victorian Institute of Technology)
Head Offi ce: Level 14, 123 Queen St, Melbourne, Victoria 3000, Australia Sydn ey Campu s: Level S, 333 Kent Street, Sydney, NSW 2000, Australia
Phone: (61) 1300 17 17 55 Email 1nfo@ v1t edu au
!ICTORIAN
NST ITUTE OF Victorian Institute of Technology Pty Ltd
ECHNOLOGY
ABN: 41085128 525 RTO No: 20829 TEOSA ID: PRV14007 CRICOS Prov ider Code 02044 E

Additional information -Applicant must complete the following questionnaire in English.

What attracts you to study in Australia and why

did you choose \/IT?

What research have you done about VIT and the

course you have applied for?

Why have you applied for this course and how

does it fit with your previous background and
career goals?

How can you justify the investment in both time

and money required to complete this course?

£JJP(~.
Applicant Signature: _ P_ "'--+/_--+
(_/ ____ I
Date: 2 2/ /1 /")11 !'g
I

Student Application Form (International) - I-lit.her Ed tdt io n I Version: 17.2 I Issue Date : 12January1018 I Review Date: 01 Ju ly 2019
Managed By: Manager Student Administration - - - - - - - - - - - ' -1-'-A:.:.. utc..:. d,~y: CEO
ho'°"r""ize<T< I Page 5 of 5
VIT (Victorian Inst itute of Technology)
Head Office : Level 14, 123 Queen St, Melbourne, Victoria 3000, Australia Sydne y Campu s: Level S, 333 Kent Street , Sydney , NSW 2000 , Austr alia
Phone: (61) 1300 17 17 SS Email . 1nfo(alv1t edu au