OFFICE USE ONLY

Application Number

Course code Receipt number

CRICOS PROVIDER CODE 00099F Print #!

in the appropriate boxes.

INTERNATIONAL STUDENT POSTGRADUATE COURSEWORK APPLICATION FORM

UNIVERSITY OF TECHNOLOGY, SYDNEY
Please use a black pen and print clearly. Do NOT use this form if you are a citizen of Australia or New Zealand or a permanent resident of Australia.
A$100.00 APPLICATION FEE

1. COURSE PREFERENCES

First choice UTS course code UTS course name

Second choice UTS course code UTS course name

When do you wish to begin your studies? ! Autumn Semester (February) ! Spring Semester (July) Year

2. PERSONAL DETAILS (as shown on your passport)

Family name/surname

Given names

Date of birth !!"

/!!"
/!!!! Sex !"
Male !"
Female

Your address in your home country (Must not be an Australian address)

Postcode/Zip code
Country code Area code Number Country code Area code Number
Tel Mobile

Email (You must provide your email address)

Your address for correspondence (or UTS representative company stamp)

Postcode/Zip code
Country code Area code Number Country code Area code Number
Tel Mobile

Email (You must provide your email address)

3. VISA DETAILS

Nationality Country of birth

Country of permanent residency Passport number

Visa category Visa expiry date (day/month/year) Year of entry into Australia
Are you already in Australia?
!"
No !"
Yes ! !!"
/!!"
/!!!! !!!!

If you hold a visa with a category other than 'student', you must include a certified copy of your visa with your application.
Name of institution
Are you currently enrolled in an Australian
institution? !" No !" Yes "
Student number
Are you currently studying at UTS? !" No !" Yes "
Provider Membership number
Do you have Overseas Student Health Cover? (OSHC) !" No !" Yes "

Are you in the process of applying for permanent residency in Australia? !"
No !"
Yes
 4. EDUCATION DETAILS

Post-secondary studies !"

No !"
Yes "List below all the courses you have/are enrolled in
Course Institution and country/state Duration (number of years) Date awarded / completed (day/month/year)

!!"
/!!"
/!!
Course Institution and country/state Duration (number of years) Date awarded / completed (day/month/year)

!!"
/!!"
/!!
Course Institution and country/state Duration (number of years) Date awarded / completed (day/month/year)

!!"
/!!"
/!!
Qualification
Do you expect to obtain a qualification this
year? !"
No !"
Yes "
Institution Country

Have you ever been excluded (or are you

Attach details on a separate sheet.
facing exclusion) from a course on academic
or other grounds?
!"
No !"
Yes " Please attach the details of your exclusion to this application form.

5. ENGLISH LANGUAGE PROFICIENCY

Is English your first language? !"

No !"
Yes If no, what is your first language?

Have you already studied in English? !"

No !"
Yes " At what level?
Name of test Date of test (day/month/year) Place Test score
Have you taken an English Test? !"
No !"
Yes " !!"
/!!"
/!!

6. EMPLOYMENT DETAILS
If the nominated course requires relevant work experience, you must fill in this section. Provide certified copies of references from your employer on
company letterhead describing your employment history. Start with your most recent position and attach additional sheets if required. Also provide a copy
of your CV/Resume.
From (day/month/year) To (day/month/year)
Dates
!Full-time !Part-time !Hours per week !!"
/!!"
/!! !!"
/!!"
/!!

Name of company Country

Job title
From (day/month/year) To (day/month/year)
Dates
!Full-time !Part-time !Hours per week !!"
/!!"
/!! !!"
/!!"
/!!

Name of company Country

Job title

7. CREDIT RECOGNITION (FORMERLY RECOGNITION OF PRIOR LEARNING)

Are you seeking credit recognition
If yes, please fill out the application form for credit recognition
for subjects from previous post
secondary study?
!"
No !"
Yes (refer to www.sau.uts.edu.au/forms) and include a copy of official subject descriptions.

8. SUPPORTING STATEMENT
If the nominated course requires you to submit a personal statement, attach a statement to support your application. State why you wish to study the course
you have nominated, your major personal/career achievements, why you consider yourself capable of succeeding in the course and how it will contribute to
your career goals (500-1000 words).

9. APPLICATION DETAILS
UTS application number
Have you applied to UTS previously? !"
No !"
Yes "
10. DISABILITY DETAILS
Description of disability
Do you have a disability or ongoing medical
condition that will require you to seek special
assistance from the university?
!"
No !"
Yes "

If yes, please attach a medical statement from a registered doctor.

11. SPONSORSHIP INFORMATION (SPONSORED APPLICANTS ONLY)

Do you already have a sponsor/scholarship from an organisation or government? !"

No (go to 12) !"
Yes (Please complete Part A)

If you do not have a sponsor/scholarship, do you intend to apply for a scholarship? !"
No (go to 12) !"
Yes (Please complete Part A)

Part A

Sponsor/scholarship name

Sponsor mailing address

Sponsor contact person Sponsor telephone

Sponsor email Sponsor fax

Please attach copies of letter of guarantee documents from your sponsor (if available)

12. FINDING OUT ABOUT UTS

How did you find out about UTS?

!"
Education exhibition !" Australian embassy !" Magazine or newspaper !"
Friends or relatives !"
UTS International !"
UTS seminar
Agent’s name

!"
UTS representative/agent
Internet search engine name

!"
Internet – which internet search engine do you use?
Please specify

!"
Other

Which factors most affected your decision to apply to study at UTS?

!"
Recommendation !"
Location !"
Course !"
Cost of living !"
Program fees
Please specify

!"
Other

13. CHECKLIST

Have you

!"
Completed all sections of this application? !"
Enclosed a certified copy of qualifications including academic transcripts?

!"
"
Enclosed a bankdraft of A$100 for the application fee or completed !"
the credit card details below
"
Enclosed copies of letter of guarantee documents from your sponsor?
(if applicable)

!"
Enclosed a certified copy of your passport? !"
Enclosed a supporting statement and/or portfolio? (if applicable)

!"
Enclosed details of English language proficiency? !"
Enclosed certified copies of references from employer(s)? (if applicable)
14. DECLARATION AND SIGNATURE

Please sign and return the following declaration. This application form MUST be signed by the applicant.

I agree I understand
> To abide by the rules of admission, > That UTS may obtain official records from any institution I have previously attended
enrolment and progression of UTS > That all documents submitted with this application become the property of UTS
> To inform UTS International immediately > That UTS may vary or cancel any decision it makes if the information I have given is incorrect or incomplete
of any change to the information I have > That UTS may be required to report to the Commonwealth Government on the progress of my application
given in this application form and/or subsequent student status
> The structure and content of the UTS course/s I am applying for in this application
I declare
> The expenses (tuition fees, living expenses and other expenses) related to the study of this course/s at UTS
> That the information given in this
> That I will be responsible for paying all the expenses related to the study of my course at UTS including the
application form and supporting
tuition fees, living expenses and other related expenses
documents is true and correct
> That in order to be admitted to the University I must meet the academic and English language requirements
> That I have access to sufficient funds
set by UTS and the Genuine Temporary Entrant (GTE) and Genuine Student (GS) criteria set by the
to cover Tuition Fee payments, living
Department of Immigration & Citizenship (DIAC). For information about the GTE and GS criteria please visit
expenses and other related expenses
www.immi.gov.au/students/_pdf/2011-genuine-temporary-entrant.pdf
incurred by me and my dependants
during my enrolment at UTS
> That I have personally signed this form

Your signature Date (day/month/year)

!!"
/!!"
/!!!!

We advise that you keep a copy of your application and all attachments for your records.

CREDIT CARD PAYMENT FOR UTS APPLICATION FEE

Applicant's name Family name/surname

Given name

Cardholder's name Family name/surname

(as it appears on
credit card) Given name

Type of credit card !"

Visa !"
Mastercard !"
Amex Amount !"
A$100
Card number Expiry date (day/month/year)
Card details
!!!!" "!!!!" "!!!!"
"
!!!! !!"
/!!"
/!!!!
Cardholder's signature Date (day/month/year)

!!"
/!!"
/!!!!

SEND APPLICATION TO
Manager, International Recruitment Note
UTS International > Admission to courses at UTS is competitive
University of Technology, Sydney > This application is not an enrolment form, and does not
PO Box 123 guarantee admission
Broadway NSW 2007
> There is no charge for this form
AUSTRALIA
Tel: 61 2 9514 1531 Certified Copies of Supporting Documentation
Fax: 61 2 9514 1530 UTS will only accept copies certified by employees from specific
organisations. Go to Step 3 of the ‘Applying at UTS’ webpage for more
Application enquiries: [email protected] information: http://www.uts.edu.au/international/prospective/studying/apply
Other enquiries: [email protected]
Web: www.uts.edu.au/international
UTS will acknowledge receipt of your application by email.

CLOSING DATES FOR COURSEWORK APPLICATIONS AN INCOMPLETE APPLICATION WILL DELAY PROCESSING.
Autumn (Feb) semester – 15 December LATE APPLICATIONS MAY NOT BE ACCEPTED.
Spring (July) semester – 15 June

UTS:MCU / JOB 17031 / AUGUST 2012