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The Language Centre - Application for Study Form

Make sure you read the following IMPORTANT INFORMATION before you submit the form. Please complete ALL sections of the form, print the form and then click the Submit button. Once the form is complete, send it to: -

The Language Centre
University of Newcastle
Callaghan 2308
New South Wales, Australia
Phone: +61 2 4921 5376
Fax: +61 2 4921 7068
Email: Language.Centre@newcastle.edu.au

1. Personal Details
Title: Mr
Mrs
Ms
Miss
Other		 Sex: Male
Female
Family Name: Given Names:
Previous Family Name:
(If Applicable)		 Date of Birth
(dd/mm/yyyy):
Home Address:
Country: Postal Code:
Telephone: Include country code Fax Number: Include country code
E-mail Address: Please print clearly
Address in Australia
(if known):
Telephone in Australia:
Nationality: Passport Number:
Type of Visa: Student Visitor Working Holiday Other - please give details
Have you ever studied at
this University?		 No Yes If Yes, Student No:

2. General Information
Usual occupation: Have you studied in Australia before? Yes
No
What is your current level of education? Have you taken an IELTS, TOEFL, Cambridge or other English test? Yes
No 
What is your current level of English?
(select appropriate)		 Elementary
Intermediate
Upper Intermediate
Advanced		 When do you wish to begin your English course? (month/year)
For how many weeks do you want to study English? weeks
Medical Conditions?: Yes
No 
 If yes, details

3. Accommodation Services
Do you require information regarding airport reception service? Yes
No 
Do you require information on pre-arranged accommodation and airport pick-up? Yes
No 
If Yes, Indicate your preferences: Homestay
On-Campus (available for 'long term stay' students)
Temporary Accommodation (Budget Hotels)

4. Application Information
Is your application being made through an agent? Yes
No
If Yes, please provide the name of the agent:
How did you find the University of Newcastle Language Centre Website? Travel Agent
 Article in Book/Newspaper
 Education Agent
Education Exhibition
 Family and/or Friends
 Australian Embassy
 Website/Search Engine
 Other (please specify)


Please be sure to read the IMPORTANT INFORMATION before you Accept the Terms and Conditions of this application and submit the form to us.

5.Terms and Conditions of Acceptance
I have read and understood the University of Newcastle 'TUITION FEE REFUND POLICY' attached this application: