Student No (office use only) Enquiry No (office use only)

UNDERGRADUATE COURSE WORK APPLICATION FORM

All DOMESTIC students applying for the Bachelor of Nursing, Bachelor of Nursing Advanced and all undergraduate Education
degrees, need to apply through the Universities Admissions Centre (UAC) www.uac.edu.au
INTERNATIONAL students please use this form to apply for all undergraduate programs including Nursing and Education.

1. PERSONAL DETAILS (USE BLOCK LETTERS)

Title: Mr Mrs Ms Miss Mx Other Gender: M F X

Family Name*

First Name*

*As shown in passport, (if applicable)

Former Family Name (if applicable)

Date of Birth d d m m y y y y

Have you previously made an application to undertake or been enrolled in a course at the UOW College or the University of Wollongong?

Yes No If YES, please give your student number

Are you a Citizen of Australia? Yes (Please provide certified documentary evidence)

No Citizenship
Country Country where you
of birth are currently located

Are you a Permanent Resident of Australia? Yes (Please provide certified documentary evidence)
Permanent Date of Permanent
visa category Residency d d m m y y y y

No

Are you Aboriginal or a Torres Strait Islander? Yes No

Mailing address Home address (if different from mailing address)

PO Box or Street Address PO Box or Street Address

Suburb/Town Suburb/Town

State/Province Postcode State/Province Postcode

Country Country

Telephone Country Code Area Code Number Telephone Country Code Area Code Number

Mobile Mobile

Prior to enrolment correspondence will normally be sent to your email address, if applicable

Email

2. COURSE APPLICATION
1st Preference Course Name Specialisation

2nd Preference Course Name* Specialisation

3rd Preference Course Name* Specialisation

*Second and third preferences will only be considered if unsuccessful with your first choice.

When do you wish to commence the degree course? (please nominate year and tick session below) Year:

Autumn session (February) Spring session (July if available) Summer session (December if available)

Southern South Western

Where do you wish to study? Wollongong Highlands# Shoalhaven# Batemans Bay# Bega# Southern Sydney# Sydney#

#Not available to international students . Course listings by campus and commencement sessions are available on CourseFinder: coursefinder.uow.edu.au

www.uow.edu.au
UNDERGRADUATE COURSE WORK APPLICATION FORM

3. SECONDARY/ TERTIARY EDUCATION

Secondary Studies

Have you completed the final two years of an Australian high school program? Yes (please provide evidence) No
State Year Result: ATAR/UAI/TER or equivalent Score Candidature No.
If yes please advise

The postcode of your permanent home address during your last year at an Australian high school.

If NO, please advise details of your Year 12 (or equivalent) performance or other tertiary qualifications in the section below.

Other Secondary or Tertiary Studies

MARKS
QUALIFICATION/AWARD SCHOOL/INSTITUTION COUNTRY ACHIEVED DURATION DATE COMPLETED

d d m m y y y y

d d m m y y y y

d d m m y y y y

d d m m y y y y

4. ENGLISH LANGUAGE PROFICIENCY

Is English your first language? Yes No If your first language is not English, please continue

I have completed at least one of the following within the last two years (documentary evidence, including certified copies of results, must be attached)

A certificate of English proficiency obtained in the last two years (eg IELTS or TOEFL)
Year Overall score Reading Writing Listening Speaking
IELTS (ACADEMIC)
Year Overall score Reading Writing Listening Speaking
TOEFL Internet based
Name of test Year Score
OTHER
Country Duration (years)
Secondary or tertiary studies in another country where English is the official language

For full information regarding UOWs English language requirements, including qualifications conducted in English, please visit: www.uow.edu.au/prospective/international/apply/english

If you do not meet UOWs English requirements are you interested in studying English at UOW College? Yes No

If yes, visit the UOWC website at www.uowcollege.edu.au for information on the programs available.

5. CREDIT FOR PRIOR LEARNING

Are you seeking credit transfer? Yes* No *You must provide a copy of your syllabus or subject descriptions with your application.

Name of institution

Some existing credit transfer arrangements can be viewed at the following websites: Australian Institutions: www.uow.edu.au/handbook/advancedstanding
International: www.uow.edu.au/future/international/apply/credit

6. CERTIFICATION OF DOCUMENTS
Certified copies of academic marksheets, transcripts and evidence of course completion must be provided with application. Details of required acceptable certification authorities for international
students can be found at: www.uow.edu.au/future/international/apply/how/certified
If you are in Australia, photocopies of documents can be certified by a Justice of the Peace, police officer, post office manager or person holding a similar professional position. The above website
provides further examples of acceptable authorities. The person certifying the document must: print their name, contact number, occupation and date verified; write This appears to be a true copy
of the original document sighted by me; affix an official organisation stamp if available; and sign each copy. Please note that any documents sent with your application cannot be returned.

7. APPLICANTS WITH SPECIAL NEEDS

If you have a disability and require advice or assistance with your studies, please contact the Disability Liaison Officers, telephone 4221 3445 or go online www.uow.edu.au/student/services/ds

www.uow.edu.au
 UNDERGRADUATE COURSE WORK APPLICATION FORM

8. ADDITIONAL REQUIREMENTS AND CLOSING DATES

Some courses require submission of additional documentation, full details of which can be found by selecting your course on the UOW CourseFinder at coursefinder.uow.edu.au or in the
undergraduate course guide.
Closing dates: See CourseFinder for the closing date for your course.

9. IMPORTANT INFORMATION FOR APPLICANTS

1. Privacy General Consent and Disclosure Statement: http://www.uow.edu.au/legal/privacy/UOW089606
2. For International Students: A description of the Education Services for Overseas Students (ESOS) Act framework is made available electronically by the Australian Government:
https://internationaleducation.gov.au/
3. Change of Name: If you have changed your name since undertaking matriculation or tertiary level examinations or if any of your documents show a name which is different from the one that you
have used on this application form, then you must present certified documentary evidence of the change (a marriage certificate, deed poll, statutory declaration).
4. Declaration and Signature: This application form must be signed by the applicant.

10. DECLARATION, TERMS & CONDITIONS AND SIGNATURE

PRIVACY AND DISCLOSURE ALL APPLICANTS
1. I declare that all the information I have given in this application is true, correct and complete, and is not false or misleading. I understand giving false or misleading information is a serious
offence under state and/or federal law in Australia.
2. I declare that the signature on this form is my signature, and has not been signed on my behalf by another person, including my agent or sponsor.
3. I agree to tell UOW College (College) and/or the University of Wollongong (University) immediately if there is any change to the information I have given in this application.
4. I understand the College/University reserves the right to vary or reverse any decision made on the basis of incorrect, incomplete, false or misleading information which I or my agent/sponsor may
have provided, including in some circumstances, termination of my enrolment.
5. I declare that I have not been excluded or subject to IF STUDYING ON A STUDENT VISA AS AN INTERNATIONAL FINANCIAL OBLIGATIONS WHILE STUDYING ON A STUDENT
disciplinary action at any tertiary institution. STUDENT VISA AS AN INTERNATIONAL STUDENT
6. I understand that the College/University may obtain 16. By nominating an agent, as listed in the contact address 24. I agree to provide any financial information requested by
official records from any educational institution I have for correspondence, to represent me in my application to the College/ University for the purpose of the College/
previously attended or my employer. the College/University, I agree to the release of all University assessing my financial ability to undertake a
7. I authorise any institution or organisation named on any information relating to my application and subsequent course of study.
document provided as evidence of my qualifications or enrolment at the College/University to my nominated 25. I declare that I have access to funding:
work experience OR which are named in my application, agent, until such time as this nomination is revoked by for the payment of all fees for the course which I am
to release to the College/University any personal me in writing. undertaking at the College/University; and
information which they may hold about me for the 17. I understand that any information provided to the for the living expenses of myself and my dependants in
purpose of verification of my supporting documents. College/University may be made available to Australian Australia for the duration of the course or courses which I
8. I authorise the College/University to release any personal Commonwealth and state government departments and have been offered, at an expected amount per individual
information they may hold about me to any other agencies, pursuant to the College/Universitys obligations of $15,000 per year (for Wollongong) and $20,000 per
educational institution which is seeking to verify my under Australian or state law, including the ESOS Act year (for Sydney).
student conduct or academic record for the purpose of 2000 and the National Code. This information may also 26. I declare that I am not relying on employment in Australia
determining my eligibility for admission to, or enrolment be made available to any company or organisation in during or following my course to pay any part of my
at, that institution. which the College/University arranges a private or public tuition and living expenses for myself and my dependants.
9. I understand and accept the terms and conditions in the work placement or practicum. This information includes,
27. I understand that I am required to pay all tuition fees in
Privacy General Consent and Disclosure Statement which but is not limited to, changes to my enrolment and any
full for my courseprior to the census date for each session/
can be viewed at: http://www.uow.edu.au/legal/privacy/ breach of a student visa condition relating to attendance
trimester/term of study, and that failure to make payment
UOW089606.html. or satisfactory academic performance.
by the required date may result in the termination of
10. If the payment for my course is made by a sponsor (a 18. I have read and understand the description of the ESOS enrolment in my course and notification to the
third party paying my tuition fees or nominated by me as Legislative Framework made available electronically by Department of Immigration and Border Protection (DIBP)
my sponsor), I agree to the release of all information to my the Department of Education and Training at http:// who may cancel my student visa.
sponsor regarding my application and subsequent internationaleducation.gov.au.
28. I understand that, in the event that I am unable to pay for
enrolment including my subject results, progress reports, 19. I understand my obligation to, and I agree to, maintain my tuition or living expenses in Australia for myself or my
and enrolment details (including contact details). I Overseas Student Health Cover for the duration of the dependants, the College/ University is not obliged to
acknowledge that I am responsible for managing my own course. provide any financial assistance (including in the form of
relationship with my sponsor, and that the College/ 20. I agree to advise the College/University of any studies that a tuition fee waiver (partial or whole), tuition fee deferral
University accepts no responsibility for and cannot control I am undertaking or will undertake at any period with or living expense support, medical expenses, legal
the relationship between myself and my sponsor. another provider which coincides witha period of study I expenses, or leave of absence consideration) and that as a
11. If I am under 18 years of age, I consent to the release of am applying to undertake or undertake at the College/ non-citizen of Australia, I do not have access to Australian
information regarding my academic performance and University. I understand that should I have obligations to government support.
attendance to my parent and/or guardian. another provider, the College/University is unable to offer 29. I understand that if I have a school-aged dependant, I will
CANCELLATION AND REFUNDS me enrolment. I understand that I must present any be required to pay full fees if that dependant is enrolled in
12. College applicants: I have read and understand the documents requested by the College/University to confirm a pre-school, child care centre, government school or
Colleges Fees and Refund Policy at: http://www. my status. non-government school.
uowcollege.edu.au/policies. 21. I understand I must enrol in a study pattern that allows 30. I understand that the College/University will not act as a
13. University applicants: I have read and understand the me to complete my course within the course duration set financial guarantor for me, and I am solely responsible for
Universitys Fees Policy (including refunds) at: http://www. in my Confirmation of Enrolment (COE). all expenses incurred by me and my dependants,
uow.edu.au/about/policy/UOW058686.html. 22. As the holder of a student visa, I understand and agree to including as the result of legal action, while I remain in
IF ENROLLED AT THE COLLEGE/UNIVERSITY abide by all the requirements of the student visa. Australia on a visa issued for the purposes of studying at
23. If I am not the holder of a student visa, I understand that the College/University, whether or not I have completed
14. I agree to be bound by all the Rules and Regulations and
it is my responsibility to ensure that the visa I hold permits the course or remain enrolled at the College/University.
any relevant policies of the College/University.
me to undertake the course in which I enrol at the APPLICABLE LAW
15. I agree to advise the College/University of my residential
College/University. 31. This agreement, and the availability of complaints and
and postal address and mobile telephone number in
Australia and of any change in my contact details. appeals processes, does not remove my right as a student
to take action under Australias consumer protection laws.
32. I understand that these terms are governed by the laws of
New South Wales and I agree to submit to the
non-exclusive jurisdiction of the courts of New South
Wales.

APPLICANT DECLARATION
By signing this form, I declare that:
1. I will abide by the College rules and policies, the University of Wollongong Act 1989, and the By-Laws, rules and policies of the University (where applicable).
2. I have read, understood and agree to abide by the above terms and conditions.
3. I consent to the use of my personal information as set out above.
4. I declare that the information provided by me in the application is true and correct. I understand that it is an offence to submit fraudulent documentation in support of a course application, and that
where fraudulent documents are detected, the application will be rejected, any offer of enrolment will be withdrawn, and the matter may be reported to relevant law enforcement agencies.

Applicants Signature Date

Applications that are unsigned will not be processed. Applications must be signed by the applicant personally. A third party must not sign on the applicants behalf.

www.uow.edu.au
UNDERGRADUATE COURSE WORK APPLICATION FORM

RETURN TO FURTHER ENQUIRIES

Admissions, Building 36 OR Within Australia International
University of Wollongong submit to a UOW representative 1300 FOR UOW (1300 367 869) Telephone +61 2 4221 3218
NSW 2522 AUSTRALIA in your country Email futurestudents@uow.edu.au Email futurestudents@uow.edu.au
Web www.uow.edu.au Web www.uow.edu.au/future/international

The University of Wollongong attempts to ensure that the information contained in this form is correct at the time of production (November 2016). However sections may be
amended without notice by the University in response to changing circumstances or for any other reason. Applicants should check with the University at the time of
application/enrolment whether any later information is available. UOW College a is a registered business name of UOWC Limited ABN 14 105 312 329. CRICOS No. 02723D.
University of Wollongong CRICOS: 00102E

www.uow.edu.au