12.

AGREEMENT
I understand that this application form, together with the offer or provisional offer letter provided to me as a result of this application, forms a written agreement with UTS:INSEARCH. The offer or provisional offer letter identifies the program or programs in which I am to be enrolled and includes any conditions that I need to meet prior to my enrolment. It also provides an itemised account of course fees that I need to pay and the Terms and Conditions. By signing this application form, returning the acceptance form and paying the fees as detailed on the offer letter or provisional offer letter provided by UTS:INSEARCH, I am confirming my acceptance of the Terms and Conditions as well as any other conditions set out in the offer or provisional offer letter, the student handbook, prospectus and any other information provided by UTS:INSEARCH. In particular, I acknowledge agreeing to the Terms and Conditions relating to Cancellation and Refunds and Transfer of Fees to other institutions. I authorise UTS:INSEARCH to have access to the Visa Entitlement Verification Online (VEVO) system to check my visa details.
Day Month Year

14. CHECKLIST FOR APPLICANTS

Please attach the following documents to this application:

* Certified copies of your final high school results * Detailed resume (if you are a mature-age applicant) * copies of your college, university transcript All certified
(if you have undertaken higher education studies)

2013 INTERNATIONAL APPLICATION FORM

GENERAL INFORMATION
All fields must be completed in order for this application to proceed for assessment Please print clearly in BLOCK LETTERS. Please tick boxes where appropriate

* All certified copies of your IELTS or TOEFL results (if required) * All certified translations of any documents that are not in English
Have you read the student academic handbook on www.insearch.edu.au? Please note applications cannot be processed without a signature and full applicant contact details on this form. If your application is successful we will send you a letter of offer (or a Provisional Offer letter if there are any outstanding entry requirements or there is any outstanding documentation).

1. WHO MUST USE THIS APPLICATION

A student who is not a citizen of Australia or an Australian permanent resident or a citizen of New Zealand; and If you are applying for an UTS:INSEARCH English course, UTS Foundation Studies program, and/or UTS:INSEARCH diploma course.

Authorised officers are: UTS:INSEARCH Student Centre Staff Staff from the institution that issued the documents A Justice of the Peace or Public Notary Staff from an Australian Embassy, Consulate or Education Centre Staff from an approved UTS:INSEARCH education representative office

Student Signature

Date

All applicants for UTS Foundation Studies or UTS:INSEARCH diploma courses must supply the following documents with their application: Certified copies* of your high school results or other academic transcripts including college and university transcripts (if you have undertaken higher education studies) Detailed resume (if you are a mature-age applicant) A certified* translation of any document that is not in English Certified* copy of your IELTS or TOEFL results (where applicable) If you have changed your name, official documents confirming this must be included Certified* copies must be accompanied by an English translation.

Print Name For students under the age of 18, a parent or guardian signature is required.
Day Month Year

15. HOW TO APPLY

FORWARD YOUR APPLICATION TO: Postal Address UTS:INSEARCH Student Admissions UTS:INSEARCH PO Box K1085 Haymarket NSW 1240 Australia [T] +61 2 9218 8666 [F] +61 2 9281 9875 [E] [email protected] www.insearch.edu.au Street Address (in person) UTS:INSEARCH Student Centre UTS:INSEARCH Ground Floor, 187 Thomas Street Sydney NSW 2000
UTS:INSEARCH CRICOS provider code: 00859D UTS CRICOS provider code: 00099F INSEARCH Limited is a controlled entity of and pathway provider to the University of Technology, Sydney. Company ABN: 39 001 425 065

You cannot certify your own documents, even if you belong to one of the categories listed above. How should the authorised officer certify each document? On the document the certifying officer must print I certify this to be a true copy of the document shown and reported to me as the original. They must write their name, address, contact telephone number, profession/occupation or organisation. The certifying officer must date and sign the document copy and include the official stamp or seal of the certifying officers organisation on the copy, if the organisation has such a stamp.

Signature

Date

*A certified copy is a photocopy signed by an authorised officer to acknowledge that they have sighted the original copy and it matches the original document exactly.

Print Name

13. FOR AGENTS

I declare that the student: Understands the Terms and Conditions in the brochure Agrees to be bound by the terms and conditions stated on this form and related documents Agrees to be bound by all Rules and Regulations of UTS:INSEARCH. I declare that all information I have given in this application is true and correct. Company Name Country Signature Agents Name

Important Note: The information contained in this form is correct at time of printing. Changes to fees, dates and information may change at any time without notice. Please visit www.insearch.edu.au for the latest information.

2. COURSE START DATES

UTS FOUNDATION STUDIES AND DIPLOMA SEMESTER START DATES FOR 2013# INTAKE START 2 SEMESTER PROGRAM 3 SEMESTER PROGRAM ACCELERATED FINISH STANDARD FINISH Feb 2013 5 Feb 2013 20 Sept 2013 24 Jan 2014 June 2013 3 June 2013 24 Jan 2014 23 May 2014 Oct 2013 30 Sept 2013 23 May 2014 19 Sept 2014 ENGLISH LANGUAGE COURSES START DATES 2012/2013# TERM START 2012 Term 10 12 Nov 2013 Term 1 31 Dec 2012 Term 2 4 Feb 2013 Term 3 11 Mar 2013 Term 4 15 Apr 2013 Term 5 20 May 2013 Term 6 24 June 2013 Term 7 29 July 2013 Term 8 2 Sept 2013 Term 9 7 Oct 2013 Term 10 11 Nov 2013 UTS COURSES 2013** SEMESTER Orientation for international students Semester 1 Orientation for international students Semester 2 UTS COURSES 2014** SEMESTER Orientation for international students Semester 1 Orientation for international students Semester 2 START 11 Feb 25 Feb 22 July 29 July START 17 Feb 3 Mar 21 July 28 July FINISH 22 Feb 28 June 26 July 29 Nov FINISH 28 Feb 4 July 25 July 28 Nov

16. ACCEPTANCE OF OFFER AND PAYMENT

Please pay in Australian dollars (AU$).   Payment to be made by bank cheque, bank draft or credit card (cash may be paid at the UTS:INSEARCH Student Centre Ground Floor, 187 Thomas Street, Sydney).  Please make cheques payable to UTS:INSEARCH.  Personal cheques are not acceptable.  signed Acceptance form must be forwarded with payment to UTS:INSEARCH The when accepting an offer of a place.

City Date / /

**Please check the UTS website for up-to-date semester dates. All international students under the age of 18 must have a carer. The carer can be either an UTS:INSEARCH approved Homestay or a relative approved by the Department of Immigration and Citizenship (DIAC). All students are required to attend Orientation. Please note that if you miss the course commencement date you may not be able to access the English level of your first choice. UTS:INSEARCH closes on Australian public holidays and for two weeks at Christmas. There is a two week break between every semester of Academic courses. The above course lengths indicate minimum duration. Applications for full-time English courses are only accepted for the full five week terms as per the published dates. UTS:INSEARCH courses will not run on Australian public holidays. For more information on UTS:INSEARCH dates and Australian public holidays please visit www.insearch.edu.au
#

17. IMPORTANT:
Please read the terms and conditions contained in your offer letter before you accept your offer.
1. UTS:INSEARCH and the University of Technology, Sydney (UTS) 1.1 All courses are offered by INSEARCH Limited; ABN 39 001 425 065 (CRICOS provider code: 00859D) (UTS:INSEARCH). UTS:INSEARCH is a controlled entity of the University of Technology, Sydney. Students are enrolled as students of UTS:INSEARCH and not of UTS. 1.2 The UTS Foundation Studies program (CRICOS course code: 068815K (Accelerated) and CRICOS course code: 068814M (Standard)) is a University of Technology, Sydney (UTS) (CRICOS provider code: 00099F) program, delivered by UTS:INSEARCH (CRICOS provider code: 00859D) on behalf of UTS at its campus in Haymarket. 2. Student Privacy 2.1 UTS:INSEARCH acknowledges and respects the privacy of students. It is required under the Privacy Act 1988 (Cth) to comply with the National Privacy Principles in respect of the collection, use and disclosure of personal information from individuals. 2.2 UTS:INSEARCH collects personal information from students for the purposes of processing applications and providing services to students. This information will be disclosed to a third party (if authorised by the student in writing) and to UTS:INSEARCH and UTS where applicable. 2.3 UTS:INSEARCH has an obligation under Commonwealth and State legislation to provide information to certain government departments. 2.4 Provision of personal information is voluntary, but if it is not provided, UTS:INSEARCH may be unable to process the students application. 2.5 Students have a right to access and alter their personal information. 2.6 Please direct any privacy enquiries you may have to: The Privacy Officer, INSEARCH Limited PO Box K1085, Haymarket NSW 1240 [T] + 61 2 9218 8600 [E] [email protected] [W] www.insearch.edu.au

3. COURSE FEES 2013

English CoursesX

UTS Foundation Studies Standard (3 Semester) Accelerated (2 Semester)

UTS:INSEARCH Diploma programs^ ( Standard - 3 Semesters and Accelerated - 2 Semesters) Diploma of: Communication (Public Relations) Diploma of: Business Design (Visual Communication) Engineering Information Technology Science $25,000 per diploma ($2,778 per subject)
^

Discount on package UTS:INSEARCH Academic package is comprised of a UTS Foundation program and a UTS:INSEARCH diploma course but can also include a preliminary English course. Students undertaking a UTS:INSEARCH academic package will receive a 5% discount off the total English tuition fees and a further 5% discount off the first 2 semesters of the Diploma course fees.

Tuition Fees (AU$)

General English (GE) Academic English (AE) IELTS Preparation

2013 2012

$475 per week $465 per week

$26,100

$19,750

$25,000 per diploma ($3,571 per subject)

866intlv3_0712

INTERNATIONAL APPLICATION FORM

To qualify, students must apply for the UTS:INSEARCH academic package program including English where necessary, and pay for all English (where applicable) and the first semester tuition fee of the UTS Foundation Studies program prior to the commencement of the English language course and/or the UTS Foundation Studies program. The international student processing fee of AU$250 is only payable once when an international student applies to UTS:INSEARCH for the first time and is non-refundable. The above diploma fees are based on no subject failures. Any diploma subject that needs to be undertaken a second time will require payment of the relevant subject fee.

4. PERSONAL INFORMATION
Please complete all sections in BLUE or BLACK INK using CAPITAL LETTERS.
Title

OFFICE USE ONLY

7. ACADEMIC COURSE SELECTION DETAILS Select the program you would like to enrol in
UTS Foundation Studies Program

* Accelerated (2 Semester - 8 months)

(CRICOS COURSE CODE: 068815K) (UTS COURSE CODE: C30015)

* Standard (3 Semester - 12 months)

(CRICOS COURSE CODE: 068814M) (UTS COURSE CODE: C30014)

When do you want to start your UTS Foundation Studies program?

* Dr

* Mr

* Mrs * Ms * Miss

* February 2013 intake * June 2013 intake * Nursing and Health Sciences * Physical Sciences (Including Engineering)
When do you want to start your diploma program?

* October 2013 intake

Family Name Given Names Previous Name (if different from the name shown above you must attach CERTIFIED documentary evidence)
Day Month Year

Please select a stream:

5. ENGLISH LANGUAGE COURSE SELECTION

/ / Country of Birth Passport No. The duration of your English course depends on your English level. All students without an official English test result (e.g. IELTS) are tested on arrival at UTS:INSEARCH. This will determine the minimum length of English learning required.

* Arts and Social Sciences * Business

Diploma Program

* Design and Architecture * Information Technology * Standard

(3 semester 12 months)

* Accelerated
(2 semester 8 months)

Date of Birth Citizenship Country of Issue

Are you a citizen or permanent resident of Australia? (Australian citizens, Australian permanent residents and New Zealand citizens must complete the Domestic Application Form) Do you currently hold a student visa? What type of visa are you applying for?

* Yes

* No

* English + Diploma * English + UTS Foundation Studies * English + UTS Foundation Studies + Diploma * Academic English (AE) * General English (GE) * AE5 * IELTS Preparation*
(CRICOS COURSE CODE: 032410F) (CRICOS COURSE CODE:032410F) (CRICOS COURSE CODE: 032422B) (CRICOS COURSE CODE: 071293E) Day Month Year Day Month Year

Please select a diploma pathway:

* February 2013 intake * June 2013 intake

Preferred course at UTS University course name Major CRICOS course Code

* October 2013 intake

* Yes * No * Tourist * Student * Other

Business * Communication (Public Relations) * Design *  (Visual Communication) Engineering * Information Technology * Science *

(Accelerated - CRICOS COURSE CODE: 070300G / Standard -CRICOS COURSE CODE: 053606J) (Accelerated - CRICOS COURSE CODE: 070303E/ Standard -CRICOS COURSE CODE: 053609F)

(Accelerated - CRICOS COURSE CODE: 070306B/ Standard -CRICOS COURSE CODE: 053608G) (Accelerated - CRICOS COURSE CODE: 070305C / Standard -CRICOS COURSE CODE: 070304D) (Accelerated - CRICOS COURSE CODE: 070299G/ Standard -CRICOS COURSE CODE: 053604M)

Starting Date Finishing Term

Finishing Date

No. of weeks applied for

(Accelerated - CRICOS COURSE CODE: 070302F / Standard -CRICOS COURSE CODE: 070301G)

Main language spoken at permanent home residence: Do you have a disability, special need or medical condition that may require extra support or specific facilities or accommodation? Provide details

*Only available for students who have reached the entry level required.

8. ACADEMIC HISTORY Full education history required - Attach certified photocopies of school, college, university certificates
LEVEL OF CURRENT AND/OR YEARS STUDIED COMPLETED HIGH SCHOOL NAME OF SCHOOL, COLLEGE OR INSTITUTION QUALIFICATION COMPLETED COUNTRY IN WHICH STUDY WAS UNDERTAKEN

* Yes

* No

6. ENGLISH LEVEL DETAILS

Please tick which of the following courses you have completed and provide the corresponding scores you achieved for each section of that course:

Home Address Overseas (must be applicants address) (Mandatory) Unit No. Street Name State Postcode Street No. Suburb Country

* IELTS

Overall:

Listening:

Reading:

Writing:

Speaking: Will you be sitting for end of year examinations? Yes No If yes, when will the results be available?

TRF (Test Report Form) no.

* TOEFL Overall: TWE/Essay: * PTE (Academic) Overall: Listening:

Day Month Year

9. ACCOMMODATION DETAILS
Reading: Writing: Speaking: Accommodation Fees ITEM Homestay DESCRIPTION Booking Fee Single Twin Share Under 18 years of age Single Under 18 years of age Twin Share AU$ (2013) $250 $295 per week $265 per week $345 per week $315 per week $150 Do you require an airport welcome? Do you smoke? Would you prefer Homestay with pets? Would you prefer Homestay with children? Do you have any allergies? If yes, please provide details Yes Yes Yes Yes Yes No No No No No

Telephone Number Overseas Country Code Mobile Number Fax Number - Overseas Country Code Email (Mandatory) Area Code Number Area Code Number Test date:

* Education conducted in English medium

Years: Place:

Airport Welcome

* Other (details)

All accommodation fees are subject to change without notice. Accommodation booking fees are non-refundable and payable once only. Twin share accommodation is subject to availability. Homestay fees include two meals per day. Prices include GST where applicable. Homestay will be arranged for a minimum of five weeks. For further information, please contact [email protected] Do you wish for UTS:INSEARCH to arrange homestay? Yes Single No Twin share

Do you have any special dietary requirements? If yes, please provide details

Yes

No

Address In Australia (if known) Unit No. Street Name State Postcode Street No. Suburb Country Representatives Details Number

If yes

10. OVERSEAS STUDENT HEALTH COVER

The Australian Government requires students on a student visa to have Overseas Student Health Cover (OSHC) for the total duration of the student visa granted. OSHC is arranged by UTS:INSEARCH when students are enrolled, on arrival at UTS:INSEARCH. Do you have OSHC? Yes No

11. HOW DID YOU HEAR ABOUT UTS:INSEARCH?

Telephone Number - in Australia Country Code Mobile Number Fax Number - in Australia Country Code Area Code Number Area Code

If you currently hold OSHC through MEDIBANK, card number: I require single cover family cover

OSHC is a Department of Immigration and Citizenship (DIAC) requirement. *Family includes the student, the spouse of the student and any dependant children of the student up to 18 years of age who have been authorised to enter and remain with the student and who are residing at the same place of residence as the student in Australia.

* School / College * Australian Education Centre * UTS * Embassy / High Commission * Education Agent / Representative Office * Friend / Relative * Exhibition * Australian Network / Study English * Advertisement. Please specify: * Other. Please specify: * Search Engine. Please specify:
INTERNATIONAL APPLICATION FORM

INTERNATIONAL APPLICATION FORM