ETI_App

APPLICATION FORM GOVERNMENT PRIMARY & SECONDARY

571 VISA (SCHOOLS)

Email application and supporting documents to: admissions.eti@dtwd.wa.gov.au

1. Personal Details Family name Given names

Preferred name

Sex (Male/Female)

Date of birth (DD/MM/YY) Home Address (outside Australia) Overseas Contact Numbers Telephone (country code/area code/number)

Fax

Mobile

Email

Local Address in Australia (if applicable)

2. Language

Telephone

Fax

What is your first language?

Mobile What language is spoken at home?

Are you studying English anywhere before commencing studies at a Government Primary or Secondary school?

3. Citizenship

If Yes where?

Yes

No

How long?

Country of birth Nationality (as shown on your passport)

4. Enrolment

Do you already hold an Australian Visa?

Passport number Yes

No

Visa Expiry Date

Visa Type

Please tick the level of schooling at which you seek admission. Please note that in Western Australia children are placed in the Year group appropriate for their age. Children commence schooling at Year 1 when they are 6 years old. * No student will Primary be enrolled into term 4 of year Secondary 11 or year 12

Year 1

Year 2

Year 3

Year 4

Year 5

Year 8

Year 9

Year 10

Year 11*

Year 12*

Year 6

Year 7

Number of years student wishes to enrol for: Commencement Date for studies (It is vital you complete this so the placing can be arranged) *List schools in order of preference: As this program runs on spare capacity it is important you identify at least 3 schools.

5. Previous Education

(1)

(2)

(3)

(4)

Highest Education

Year

Country

Name of School

Year level studied

Period of Study

Please attach transcripts of your most recent schooling results

Have you studied at another school in Australia before coming to Education & Training International?

If Yes,

Year

Name of School

Year level studied

Period of Study

Yes

No

Have you been at this institution longer than 12 months?

Yes

No If no – you will need to provide a release letter

Do you have Overseas Health Cover with this institution?

Yes

No Expiry Date

6. Special Needs Do you have a physical disability or learning difficulty that may require additional programs, equipment or support?

Yes

(Please refer to Page 16 of this handbook for clarification)

Please fax/post application to:

223 Vincent Street, West Perth 6005 Perth Western Australia Tel: 618 9227 5538 | Fax: 618 9227 5540 Email: info@link2uni.com

www.link2uni.com

No

7. Care & Welfare Arrangements Students enrolling into a Government Primary School must be accompanied to Perth with a parent for the duration of their studies.

Students enrolling into a Government Secondary School can nominate a blood relative over the age of 21 to be their Guardian (this can be parents, grandparents, aunt, uncle, brother or sister), please be advised if choosing this option Education & Training International will not be issuing a welfare letter for visa purposes, the family are to contact Immigration direct. Alternatively Education & Training International can arrange a local carer and homestay family on your behalf, Education & Training International will then issue the welfare letter for the student. Please complete the below School Welfare Arrangements.

8. Primary School Welfare My Child will be residing in Western Australia for the duration of his/her student visa with: Arrangements Mothers Name

Mothers Signature

or Fathers Name

Fathers Signature

I understand that I cannot under any circumstances leave my child in the care of any other persons. Failure to abide by the local carer agreement, set by Education & Training International will result in your enrolment being cancelled. You will be sent a welfare form to be completed with the offer letter if your child is successful in obtaining a place.

9. Secondary School Welfare We have nominated a local carer/guardian for our child Yes No (Complete below details) Arrangements We require Education & Training International to nominate a local carer / guardian for our child Yes

No

(Students will then be placed in Homestay with the local carer / guardian for the duration of their stay – more information will follow on the family details once the enrolment has been confirmed) Complete if parents have nominated a local carer / guardian: (Please note: ETI will not be issuing a welfare letter if this option is picked. Contact Immigration Direct) Name of Local carer / guardian Relationship to student (must be a blood relative) Address in Perth Telephone Number

Email address

Do you require airport pickup from Perth International Airport?

Yes

No

There is an additional cost of $55.00 per person

10. Agent Declaration I of confirm that I have counselled and brief the applicant and Details about ETI policies and procedures and the terms and conditions related to this application in accordance with our agent agreement with Education & Training International.

Agent Name

Agent Telephone Number

Agent Fax Number Would you prefer offer letter

Agent Email Address Faxed

Emailed

11. Declaration Information provided by the applicant may be made available to State and Commonwealth agencies and parents and guardians. I certify that the information on this form and supporting documentation are complete and correct. I acknowledge that the provision of incorrect information or documentation or the withholding of information or documentation relating to my application may result in the cancellation of my enrolment.

By signing this application form I agree to the following: • Ensure that my child remains in the care of the nominated local carer / guardian as agreed by Education & Training International • Be responsible for any return airfares, living expenses and any additional costs associated with my child attending a Government school.

• Attend school in accordance with the Australian Government student visa policy.

• Abide by the policies of the Department of Education & Training Western Australia and the school at which I will be enrolled.

Applicant’s Name (if entering Secondary schooling) Signature

Date

Parent’s Name (this form will not be processed unless signed by the parent) Parents Signature Relationship to Student (mother / father) Please note: Completion and lodgment of this form does not necessarily guarantee you a place in Western Australia Government School. *If these sections are not completed the application will be returned.