ELICOS Only applications

ELICOS Only - Application for Study Form

Please complete ALL sections of the form. Once complete, print the form and 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

Important: Make sure you read the following Terms and Conditions of Acceptance before you submit the form.

1. Personal Details

Title:



Sex:
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:


Have you ever studied at this University?
If Yes, Student No:

2. General Information

Usual occupation:
Have you studied in Australia before?
What is your current level of education?
Have you taken an IELTS, TOEFL, Cambridge or other English test?
What is your current level of English?
(select appropriate)


When do you wish to begin your English course? (month/year)
For how many weeks do you want to study English? weeks
Medical Conditions?:

If yes, details

3. Accommodation Services

Do you require information regarding airport reception service?
Do you require information on pre-arranged accommodation and airport pick-up?
If Yes, Indicate your preferences:

4. Application Information

Is your application being made through an agent?
If Yes, please provide the name of the agent:
How did you find the University of Newcastle Language Centre Website?






Please be sure to read the IMPORTANT INFORMATION before you accept the Terms and Conditions of this application and send the completed form to us.

5.Terms and Conditions of Acceptance

I have read and understood the University of Newcastle 'TUITION FEE REFUND POLICY' attached to this application.