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Study Abroad/Exchange
Application Form

Agent / Representative's Stamp and Address
Office Use Only

A   ____________

S   ____________
 
Closing Dates for Applications: 30 November for Trimester 1 entry
31 December for Semester 1 entry
31 March for Trimester 2 entry
31 May for Semester 2 entry
31 July for Trimester 3 entry
 
 1. Personal Information
Please tick the appropriate circles and print clearly in BLOCK letters
Title:
   Mr    Mrs    Ms    Miss    Other    		   Gender:
Male
Female
Family Name:
  
Other Name(s):
   
Date of Birth:
Day Month Year
Permanent Address:
State/Province: Country: Postcode:
Telephone: Home:
 
Business:
Fax:            Home:
 
Business:
Email:
Country of Birth:
  
Country of Citizenship:
 

Which type of study program are you applying for:
 
 2. Disability / Special Needs
Do you have a disability, or long term medical condition which may affect your studies?

No   Yes

If yes, please contact the Disability Liaison Officer (Callaghan Campus) or the Student Support Welfare Officer (Ourimbah Campus) who can advise you on how the University can accommodate your needs:

The Disability Liaison Officer
Disability and Student Support Unit
Telephone: (+612) 4921 7304
Telephone Typewriter: (+612) 4921 7040
Facsimile: (+612) 4921 7065
Email: dis-students@newcastle.edu.au

The Student Support Welfare Officer
Student Support Unit
Telephone: (+612) 4348 4066
Facsimile: (+612) 4348 4065
Email: jmckay@mail.newcastle.edu.au
 
 3. Preferred Courses
I plan to study in: Month: Year:  
I will be studying for: One Semester
 One Trimester		 One Year
 Two Trimesters		  

I will be studying at (tick one only): Callaghan Campus Ourimbah Campus

Campus Note: Most courses are offered on the main campus at Callaghan. However, some courses are offered on the Ourimbah (Central Coast) Campus, which is 1.5 hours travel south of Newcastle. Please check your course information carefully (including any assumed knowledge or pre-requisites). Further information regarding course descriptions and timetables is available at http://studinfo3.newcastle.edu.au/cts/handbook/handbookSubjectSearch.cfm
Course Code: Semester:
 February July
Course Name: Trimester:
 Jan May Sept
     
Course Code: Semester:
 February July
Course Name: Trimester:
 Jan May Sept
     
Course Code: Semester:
 February July
Course Name: Trimester:
 Jan May Sept
     
Course Code: Semester:
 February July
Course Name: Trimester:
 Jan May Sept
     
Course Code: Semester:
 February July
Course Name: Trimester:
 Jan May Sept
     
Course Code: Semester:
 February July
Course Name: Trimester:
 Jan May Sept
     
Course Code: Semester:
 February July
Course Name: Trimester:
 Jan May Sept
 
 4. English Language Proficiency
If you are applying on the basis of overseas qualifications and/or you are not a permanent resident, you MUST attach either:
  • a certified copy of IELTS, or other English equivalent test results (e.g., TOEFL) taken in the last twenty four months (24) ; or
  • a certified statement from your prior institution stating that English was the language of instruction
My first language is English
Further information regarding English language proficiency requirements is available at our policy library.
 
 5. Academic Record

You must submit with your application:

  • Certified academic transcripts of all previous tertiary studies showing all courses attempted, including failures marks or grades (Please send original documents - copies will be accepted only if they are certified); and , if applicable
  • Certified translations of any original documents that are not in English.
Name of Institution

   Country:
Degree:

   Year Studied :  
Qualification or Stage Attained:
   Overall GPA:  
Name of Institution

   Country:
Degree:

   Year Studied :  
Qualification or Stage Attained:
   Overall GPA:  
You are currently:
 Freshman/1st Year
 Sophomore/2nd Year
 Junior/3rd Year		   Senior/4th Year
 Graduate
     
Courses in which you are currently enrolled   Period of Study
  From
    To    
  From
    To    
  From
    To    
  From
    To    
 
 6. Additional information
Written approval to participate in the University of Newcastle's Study Abroad program must be submitted from a Dean or Foreign Study Advisor at your home institution.
If there are any special circumstances affecting your application that you wihs to be considered, you may attach a statement.
 
 7. Declaration

I declare that the information I have supplied in this application is correct and complete. I understand that the University may vary or cancel any decision it makes if the information I have supplied is found to be incorrect or incomplete. I recognise that it is my responsibility to provide all documentary evidence requested in this application. I authorise the University to obtain further information where deemed necessary. I agree to comply with the rules governing admission and enrolment of the University. I understand that I am responsible for the prompt payment of any fees related to the program to which I am applying for admission.

I understand that the University may be required to release the information supplied to Commonwealth and State agencies, pursuant to obligations under the Education Services for Overseas Students Act 2000 and the National Code of Practice for Registration Authorities and Providers of Education and Training to Overseas Students and I hereby authorise the release of information contained in the Apllication Form to such agencies.

I understand that the University is required by law to inform the Department of Education, Training and Youth Affairs of changes to my enrolment and any breach of a student visa condition relating to satisfactory academic performance.

Signature …………………………………………………………         Date ……………………………..
 
 

SEND YOUR COMPLETED APPLICATION FORM TO:

International Admissions
Student Administration Unit
The University of Newcastle
University Drive
Callaghan
NSW 2308
Australia

Phone: (+612) 4921 6595

Fax: (+612) 4960 1766

Email: study-abroad@newcastle.edu.au
Note:
If you are filling in this form on the web, you should complete the whole form and PRINT it out BEFORE following any link to another page. If you do not, then when you return to this form, the information you have already entered may not be there.