Student Application

1. PERSONAL DETAILS

TITLE *

FIRST NAME *

MIDDLE NAME (IF APPLICABLE)

LAST NAME *

DATE OF BIRTH *

GENDER *

MALEFEMALE

ARE YOU MARRIED? *

YESNO

DO YOU HAVE ANY CHILDREN? *

YESNO

USI NUMBER (IF APPLICABLE)

ARE YOU LODGING THIS APPLICATION FROM OVERSEAS OR WITHIN AUSTRALIA?

I AM OVERSEASI AM IN AUSTRALIA

MOBILE *

EMAIL *

ALL COMMUNICATION WILL BE DONE VIA EMAIL, SO PLEASE PROVIDE AN EMAIL THAT WILL BE CHECKED REGULARLY

2. Address in Australia

STREET ADDRESS *

STATE/TERRITORY *

SUBURB *

ZIP/POSTAL CODE *

ARE YOU CURRENTLY LIVING AT THIS ADDRESS?

YESNOI WILL NOT BE LIVING HERE

PLEASE NOTIFY KCBT OF ANY CHANGES OF ADDRESS OR CHANGES OF OTHER CONTACT DETAILS THAT MAY OCCUR WHILE THEY ARE ENROLLED WITH KCBT

3. ADDRESS IN HOME COUNTRY

STREET ADDRESS *

COUNTRY *

STATE/REGION/TERRITORY/PROVINCE

ZIP/POSTAL CODE *

4. EMERGENCY CONTACT

NAME *

FIRST
LAST

RELATIONSHIP TO YOU

EMAIL *

MOBILE

ADDRESS

IS YOUR EMERGENCY CONTACT IN AUSTRALIA?

YESNO

5. PASSPORT AND VISA DETAILS

DO YOU CURRENTLY HOLD A VALID AUSTRALIAN VISA? *

YESNO

YOUR NATIONALITY *

COUNTRY OF BIRTH *

PASSPORT NUMBER *

PASSPORT EXPIRY DATE *

ARE YOU OF ABORIGINAL OR TORRES STRAIT ISLANDER ORIGIN? *

NOYES, ABORIGINALYES, TORRES STRAIT ISLANDER

SUBMIT COPY OF YOUR DOCUMENTS

Accepted file types: jpg, pdf, file, file size: 100 MB.

6. Disability

DO YOU CONSIDER YOURSELF TO HAVE A DISABILITY, IMPAIRMENT OR LONG-TERM CONDITION? *

YESNO

7. Student's English Ability

WHAT IS YOUR FIRST LANGUAGE? *

HOW WELL DO YOU SPEAK ENGLISH? *

VERY WELLWELLNOT WELLNOT AT ALL

HAVE YOU UNDERTAKEN AN ENGLISH LANGUAGE COURSE IN AUSTRALIA? *

YESNO

HAVE YOU SAT AN IELTS, TOEFL OR PEARSON ENGLISH TEST? *

NOIELTSTOEFLPEARSON

OVERALL BAND *

UPLOAD ENGLISH RESULTS

Accepted file types: jpg, pdf, Max. file size: 10 MB.

8. Schooling Information

WHAT IS YOUR HIGHEST COMPLETED SCHOOL LEVEL? *

IN WHICH YEAR DID YOU COMPLETE THAT SCHOOL LEVEL? *

ARE YOU STILL ATTENDING SECONDARY SCHOOL? *

YESNO

UPLOAD HIGH SCHOOL ACADEMIC RESULTS

Accepted file types: jpg, pdf, Max. file size: 10 MB.

9. Previous Qualification Achieved

Did you enroll in or complete any qualification with KCBT in the past? *
YesNo

Have you successfully completed any other qualification? *
YesNo

COURSE CREDIT OR RECOGNITION OF PRIOR LEARNING (RPL)

There is no cash refund for credit transfer requests. Should you be applying for this prior to enrollment, the final fee remains the same – COE issued.

Do you wish to apply for course credit or recognition of prior learning (RPL)? *
YesNo

10. Study Reason

Of the following categories, which best describes your main reason for undertaking this course/US? (Select only one) *
To get a jobFor personal interest or self-employedTo develop my existing skillsTo start my own businessI wanted extra skills for my jobTo get a better job or promotionIt was a requirement of my job

11. Employment

Of the following categories, which best describes your current employment situation? (Select only one) *
Full-time employeePart-time employeeEmployerEmployed - unpaid worker in family businessSelf-employed (not employing others)Unemployed - seeking full-time employmentUnemployed - seeking part-time employmentNot employed - not seeking employment

12. Course Information

Course 1 *

Intake / Month / Year *

Start Date *

Please note: You can choose which Monday you would like to start on.

Course 2

Special consideration and arrangements required (Please note if you require KCBT’s approval):

Please visit our website for further details regarding intake dates and prices: KCBT Courses Details

KCBT can’t guarantee the availability of your selected schedule.

13. Campus

Select Campus *

14. Marketing

I would like to receive update newsletters from KCBT *
YesNo

Are you using an education agent? *
YesNo

15. Medical Coverage

Do you want KCBT to arrange Overseas Student Health Cover (OSHC)? *
Yes, me onlyYes, me and my partnerYes, me and my family (including my children)No

16. Accommodation

Keystone College Business and Technology has teamed with the Australian Homestay Network – WA (AHN – WA)
to give KCBT Students the opportunity to be hosted by a specially trained AHN homestay host
for a safe and happy introduction to living and studying in Australia.

If students require Accommodation Services and Airport Pickup,
they may refer to the Australian Homestay Network.

Student Signature

I confirm that *
I have read and understood the College General Terms and Conditions and Refund Policy, and I further agree to be bound by them.

Full name of the person who made the declaration *

I have read and understood the information provided on the KCBT website
(which covers the course content and duration, qualification offered if applicable,
modes of study and assessment methods (under Course information) and in the KCBT student handbook).
I declare that the information I have provided is true and correct. I am aware of the consequences
that may arise from providing false, misleading, or incomplete information, including the cancellation
of my enrolment or the withdrawal of any offer made by KCBT.

VET Data Use Statement

Under the Data Provision Requirements 2012 and National VET Data Policy
(which includes the National VET Provider Collection Data Requirements Policy),
Registered Training Organisations are required to collect and submit data compliant with AVETMISS
for the National VET Provider Collection for all Nationally Recognised Training.
This data is held by the National Centre for Vocational Education Research Ltd (NCVER),
and may be used and disclosed for the following purposes:

populate authenticated VET transcripts;
facilitate statistics and research relating to education, including surveys and data linkage;
pre-populate RTO student enrolment forms;
understand how the VET market operates, for policy, workforce planning and consumer information;
administer VET, including program administration, regulation, monitoring and evaluation.

You may receive a student survey which may be administered by a government department
or NCVER employee, agent or third-party contractor or other authorised agencies.
Please note you may opt out of the survey at the time of being contacted.
NCVER will collect, hold, use, and disclose your personal information in accordance with
the Privacy Act 1988 (Cth), the National VET Data Policy,
and all NCVER policies and protocols (including those published on NCVER's website at
www.ncver.edu.au).

If you would like KCBT to apply for a USI on your behalf, you must authorise us to do so
and declare that you have read the privacy information at

http://www.usi.gov.au/Training-Organisations/Pages/Privacy-Notice.aspx
. You must also provide some additional information as noted at the end of this form
so that we can apply for a USI on your behalf.

I will immediately notify KCBT of any changes to the information I have given in this application form.
If I do not commence my course, my COE will be cancelled under Non-Commencement of Studies,
and DoHA will be informed about it via PRISMS. KCBT reserves the right to vary or reverse
any decision regarding admission or enrolment made on the basis of incorrect or incomplete information.

I am fully responsible for all education and living expenses, as well as the dependants that accompany me
while I am studying at KCBT. It is my responsibility to provide KCBT with all necessary original
and certified documentation and evidence of qualifications mentioned in this application
and to ensure that they are true and complete in every particular. Cancellation fees will be applied.
I cannot change my education provider during the first six months of my course without a written
letter of release from KCBT.

If I apply for a refund of the fee, it will be treated according to KCBT's Refund Policy
available on the KCBT website and attached with this form.
KCBT will send official communication relating to my studies via post at my preferred postal address
that I provided at the time of enrolment. KCBT reserves the right to change course start dates,
course curriculum, and programs at any time. Students will be advised prior to the changes.
My photographs, videos, and information may be used by KCBT for news and event purposes
on the KCBT website and other publications.

If you are unable to submit your documents with this form, please email them to:
enrolment@kcbt.edu.au
or post to:

Keystone College of Business and Technology

HEADOFFICE: Level 7, 251 Adelaide Terrace, PERTH 6000 WA, AUSTRALIA

PH: +61 8 9221 1261

APPLICATION CHECKLIST

Complete all sections of the application form
Attached evidence for credit or exemption
Provide details if you already have a student visa and/or OHSC
Passport biodata page
Academic record/qualifications
English test results