International Students Application Form – Intech: Institute of Technology

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Your personal details
We will contact you be email or telephone. To avoid delays in your application, it is important you complete ALL of your details clearly including your email address.
Name (as shown in passport)*
First Last
Use your legal name as shown on your passport. This name will appear on your academic record as well as your diploma parchment upon graduation.
Gender*
Date of Birth*
Will you be the age of 18 when your course commences?*
- Yes
- No
Email*
Telephone*
Residential Address outside Australia (as shown in passport)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
*MUST include postcode
Mailing address (if different from above):
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Student Nationality
Country of birth:*
Nationality/Citizenship on passport:
Passport Number:*
Have you visited or studied in Australia previously?
- Yes
- No
Have you breached any visa conditions?
- Yes
- No
Have you ever been refused a visa for entry into Australia?
- Yes
- No
If Yes, please provide details below.
Have you ever been convicted of a crime or offense in any country?
- Yes
- No

Dependent background
What is your relationship status?
- Single
- Married/De Facto
- Separated/Divorced
Has she/he previously applied for an Australian visa?
- Yes
- No
If you have a partner, is she/he coming to Australia as a dependent on your student visa?
- Yes
- No
If yes, provide her/his name
Do you have any children?
- Yes
- No
If yes, how many will accompany you to Australia

Emergency Contact
*Student's immediate family only
Name*
Prefix First Middle Last
Relationship to applicant*
Phone
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Do you have any relatives or friends in Australia?
- Yes
- No
If yes, please provide details below:
Full Name Relationship to you State they live in

Supporting Documents
Please attach electronic copies of original documents to support your application.
I am submitting my passport
Please upload a clear copy of the first and last page of your passport
I am submitting my IELTS results
Other Documents
Drop files here or
Student Declaration
All students must read the following information and sign
*
- I declare that the information I have provided on this form is correct and complete.
- I understand that giving false or incorrect information may lead to the refusal of my application or cancellation of enrolment. I give Intech Institute of Technology permission to obtain official records from an education institution that I do and/or have attended.
- I understand that if I have applied through an approved Intech Education agent, all correspondence relating to my application will be forwarded to that agent
- I understand that Intech Institute collects, stores and uses personal information only for the purpose of administering prospective, current and graduate student admissions, enrolment and education and that information collected is confidential and will not be disclosed to third parties without my consent, except to meet government, legal or other regulatory authority requirements.
- I understand that I must meet all requirements associated with my chosen course, and/or funding arrangement, prior to my enrolment being accepted.
- I authorise Intech Institute to contact me by email or SMS.
- I have read the terms and conditions overleaf. I acknowledge and accept the terms and conditions of the college.
General privacy statement
Intech Institute of Technology Pty Ltd will meet the requirements of the Privacy Act 2001 in relation to the protection of student information. Intech Institute of Technology Pty Ltd is required under the Section 19 of the ESOS Act 2000 to inform DIAC about changes to enrolment details and breaches to visa conditions. Information supplied by the student may be available to Commonwealth and State Govenment Departments or their agencies and the Fund Manager of the ESOS Assurance Fund pursuant to obligations under the ESOS Act 2000 and the National Code 2007.
Student Name
I hereby accept the form as signed
Parent/Guardian Name (If student is Under 18)
I hereby accept the form as signed
Date

Please provide a detailed answer for each of the following questions. The statement must include: your reasons for choosing Intech Institute and the course of study specified in your application form, your reasons for choosing to study in Australia rather than your home country, the key aspects of this course that interest you, the relevance of the course to your future career/educational plans, particularly in your home country.*
If the space is insufficient, attach an additional statement. We encourage you to conduct in-depth research about Intech Institute and your chosen program via our website: www.intech.edu.au
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Step 1 of 8

Your personal details

Student Nationality

Dependent background

Emergency Contact

Course Preference

English Language Proficiency

Supporting Documents

Student Declaration

General privacy statement

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