Off-campus coursework undergraduate application
» Please complete all sections and print neatly in BLOCK LETTERS.
» Include certified/notarised evidence of academic qualifications and English language proficiency.
» Enclose a non-refundable A$55 ($50+10% GST) application fee (bankdraft made payable to
Deakin University or complete the payment by credit card details on the other side of this form).
» Return this form and attachments to:
Deakin International, 221 Burwood Highway,
Deakin University, Burwood, Victoria 3125 Australia
Fax: +61 3 9244 5094
» Closing date for applications:
» for studies commencing semester 1: 30 November
» for studies commencing semester 2: 31 May
Personal details
Title (Dr, Mr, Mrs, Ms, Miss) Family name Given name(s)
Date of birth (day / month / year) / / Male Female
Permanent address in home country (If you change your address please advise this office immediately.)
Full address
Country Postcode
Email
Telephone* ( ) Mobile* ( )
Country and Number Country and Number
Area Code Area Code
Address for correspondence (Only if different from address in home country.)
Full address
Country Postcode
Email
Telephone* ( ) Mobile* ( )
Country and Number Country and Number
Area Code Area Code
Citizenship
Country of citizenship (as on passport) Country of birth
Have you applied for Australian Permanent Resident status? Yes No If yes, the date of application / /
Visa type (e.g. student, visitor) Visa expiry date / / Passport number
Course preferences
Indicate your preferred course of study and campus including course codes and titles.
Course code Course title (Major sequence) Campus Start date
Example A726 Master of Arts (International Relations) B Semester 1 2009
1st preference
2nd preference
Note: Semester 1 starts in mid-February and Semester 2 starts in mid-July.
English language proficiency
You must provide documentary evidence of your English language proficiency to meet Deakin’s English language requirements.
Please tick the appropriate boxes. 1) English is my first language Yes No
2) I have sat an IELTS test Yes No (Attach results)
3) I have sat a TOEFL test Yes No (Attach results)
* By supplying your mobile number, please be aware you may receive reminders/notices by SMS. Deakin University CRICOS Provider Code: 00113B
2) Off-campus coursework undergraduate application
Applicant’s name: __________________________________________________
Single unit applicants–unit selection
Are you applying for single units to gain membership into a professional association? Yes No
Off-campus students who have not undertaken formal study in recent years are advised to initially select one or two units (credit points) per semester. A full-time load is
equivalent to 4 credit points. List units in order of preference. Although no guarantees can be given, the faculty will attempt to accommodate your request. If quotas are applied
to some units, it may not be possible to allocate your higher preferences.
I would like to study units per semester.
Semester 1, Year Semester 2, Year
Unit code Unit name Unit code Unit name
1st preference
2nd preference
3rd preference
Education
Provide details of all secondary/tertiary studies undertaken (attach certified/notarised copies of results):
Years enrolled Full-time Successfully
Name of course/award Institution Country/State
(e.g. 1995-97) or part-time completed (yes or no)
Are you applying for advanced standing? (i.e. credit transfer) Yes No
Are you a current or former Deakin University student? Yes No If yes, Deakin University student number _________________________________
Employment history (if applicable)
Please attach a more detailed statement if necessary.
Employer’s name From To Description of responsibilities
Special requirements
I have a medical condition or a disability that requires support while I am at Deakin, and have attached a separate statement explaining my needs.
I have provided/will provide any additional application documentation (e.g. folio, personal statements, etc.) as outlined in the course description in the courses section.
Checklist
I will forward required documentation as soon as possible.
I have read the sections of this Guide relating to the courses I have selected, admission procedures, fees and refund policy.
I have paid the A$55 ($50+10% GST) non-refundable application fee.
I have attached certified/notarised documentary evidence of all my academic studies and associated application documentation (including studies not completed) and
grant approval to Deakin University to verify my academic documentation with my previous institutions.
I have attached certified/notarised documentary evidence of English language qualifications.
I have attached employment history details (where applicable).
I have attached two Referee Reports (where applicable).
Declaration
I declare that to the best of my knowledge the information I have supplied in this application and the documentation supporting it is correct and complete.
I will provide original documentation as required and acknowledge that the provision of incorrect information or documentation or the withholding of relevant information or documentation relating to
this application may result in cancellation of any offer of enrolment or actual enrolment by Deakin University. I have read and understood the sections of this Guide relating to the courses I have selected,
admission procedures, fees and refund policy. I undertake to make timely payments of any fees or associated costs for which I am liable. I am aware of the likely costs of my stay in Australia and have the
necessary financial capacity to meet such costs for the duration of my course.
Applicant’s signature ___________________________________________________________________________ Date / /
Please visit www.deakin.edu.au/disclaimer/ for privacy information.
Payment of application fee by credit card
Please charge A$55 ($50+10% GST) non-refundable application fee to my (please tick) Visa Mastercard
Card number Expiry date /
Cardholder name: _________________________________________________ Cardholder signature: ______________________________________________
* By supplying your mobile number, please be aware you may receive reminders/notices by SMS. Deakin University CRICOS Provider Code: 00113B
