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Student application

Please Note:

  *Indicates mandatory fields
1. Applicant's Name:
Title(Mr/Mrs/Miss/Ms):
*Given name/s:
*Surname:
2. Home address:
*No. and street (PO Box)
*Suburb/town/city:
*Postcode
*Telephone: (please include area code)
E-Mail address: (if applicable)
Holiday address:
No. and street (PO Box):
Suburb/town/city:
Postcode:
Telephone: (please include area code)
Holiday from: to:
3. Gender and age:
Gender:

Age:
Date of birth:

4. School results:
Year 10 results - completed in
Subjects Achievement level
English







Year 11 results - completed in
Semester 1
Subjects Achievement level
English







Semester 2
SUBJECTS Achievement level
English







Year 12 results - completed in
Semester 1
Subjects Achievement level
English







Semester 2
Subjects Achievement level
ENGLISH







Mature age entry:
Level of schooling (completed or current) Yr 9 Yr 10 Yr 11 Yr 12
When did you leave?
5. Course/program applied for at:
(List in strict order of preference. Only one course per line please.)
Preference 1
Course name: Course number: Mode:



Preference 2
Course name: Course number: Mode:



Preference 3
Course name: Course number: Mode:



6. Studies since leaving school - show all successful attempts:
Course or subject passed Institution Year completed
7. Paid/Unpaid employment or other work experience, including school:
Occupation Type Work experience Duration months-weeks
8. Special entry
If you do not meet the entry grade level, you may apply for special entry. Please mark the appropriate box:
SA Aboriginal or Torres Strait Islander
SC Study affected through long-term illness or major accident
SD Disadvantaged socially or economically
SL Language difficulties affected study
SM Professional experience and/or other special consideration for mature-age applicants
SO Other: Please seek additional information from the College (Student Support Services are available for ATSI students at many Colleges)
9. Disability. If you have any physical/sensory/intellectual disability, please specify below:
10. Supporting reasons. Give reasons why you want to study the program you have chosen:
11. Residential status. This section must be completed:
Australian Citizen
Permanent Resident of Australia
New Zealand Citizen
None of Above

Is English your first language? - 		Holder of Temporary Resident Visa

(i) Type of temporary visa which you hold or expect to hold:

(ii) Country of citizenship:
12. Declaration
I declare that the information on this application is correct and agree to provide any evidence required of my eligibility prior to, or at the time of enrolment.

Applicant�s signature:
______________________________ (where printed copy is used)
Date:

I declare that the information on this application is correct and agree to provide any evidence required of my eligibility prior to, or at the time of enrolment.

Signature of Parent/Guardian if applicant is under 18 years:
______________________________ (where printed copy is used)
Date:
Submitting your application
Privacy Declaration - The Department of Education and Training is collecting the information on this form to assess applications for admission to WideBay TAFE. Only authorised departmental officers have access to this information. Your personal information will not be disclosed to any other third party without your consent, unless authorised or required by law.
To send your Request click the 'Submit' button.