Student Registration Form

Note: * indicates required information
Study in Australia
  Student Type
  Have you previously studied in Australia
  If you have a promotional code, enter it here
  Referrermail

Personal Information
  Salutation  
  * First Name  
  * Last Name  
  * Date of birth  
  * Gender M  F   
  * Nationality (as shown on passport)  
  * Email address  
  * Confirm email address  
  * Home Phone ( )  
  Work Phone ( )  
  Mobile (for sms course offer updates) ( )  
  Fax ( )   

Contact Information
  Mailing Address
  * House/Unit Number * Street Name  
  * Suburb/Town * State  
  * Postal Code * Country  
           
  Home Address
  House/Unit Number Street Name  
  Suburb/Town State  
  Postal Code Country  

Study Preferences
    Institution Type Category of Study Location
  * First Preference
  Second Preference
  Third Preference
  Fourth Preference
   
  * Preferred study commencement date
  * Preferred length of study
1 to 10 weeks 10 to 50 weeks 1 to 5 years

Visa / Finance
  Do you require specialised assistance with obtaining a Visa? Yes:
  Do you currently have the neccessary funds for study?

Special Requests / Comments
Word Verification

Please enter above letters:

Declaration
  I hereby consent and authorise IAE P/L & EMA Pty Ltd to forward the information above and other information provided to the education providers in order to facilitate my enrolment and acceptance by any Cricos or EMA P/L chosen educator(s) and I acknowledge that IAE P/L and or EMA P/L may receive consideration from the educator that receives my referral. I hereby declare that the information provided on this application is correct. I authorise IAE Pty Ltd & EMA Pty Ltd to obtain official records if necessary, from TISC, VTAC, UAC, QTAC, SATAC, UT, SSC (India) and/or any other education institution attended by me. I understand that if any information provided is false, this application may be cancelled and I may be liable for the referral fee.  
 
* I Agree: