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Course of Interest

Question 1: Which Campus course/qualification are you applying for?

Course Code (if known)

Course Name*

Question 2: What is your preferred study mode?

OnlineFace-to-Face

Question 3: Are you interested in applying for on-site student accommodation (Halls)?

YesNo

Personal Details

Question 4: What is your full name?

Your Given Name/s*

Your Family Name*

Question 5: Have you been known by any names other than the name you entered for question 4?

YesNo

Previous Name/s*

Question 6: What is your birth date?

Question 7: What is your gender?

malefemaleother

Question 8: What are your contact details?

Preferred Phone*
[phone* your-phone]

Your Email*

Alternative Email (optional

Question 9: What is the address of your usual residence?

Building/Property Name (optional)

Flat/Unit Details (optional)

Street/lot number*

Street name*

Suburb, locality or town*

State/Territory*
ACTNSWNTQLDSATASVICWA

Post Code*

Question 10: What is your postal address (if different from above)?

Same address as above

Building/Property Name (optional)

Flat/Unit Details (optional)

Street/lot number

Street name

Suburb, locality or town

State/Territory
ACTNSWNTQLDSATASVICWA

Post Code