International student

Application for admission to Higher Degree

by Research Candidature and Scholarship

Instruction Guide
Read these instructions carefully before you complete the application form.
Please complete all questions (with the exception of those questions for
completion by your supervisor), and sign and date the application form.
n Please use BLOCK LETTERS
n Please tick ✓ the appropriate boxes
DO NOT complete this form if you are an Australian or New Zealand Citizen, or hold Australian Permanent Residency.
Refer to www.research.swinburne.edu.au/research-students/documents/Domestic_Stud_Research_app_form_Sept_2014.pdf
This form should be used when applying for candidature in a Doctor of Philosophy, Professional Doctorate or Master by Research Program.

PERSONAL DETAILS
Please provide documentary evidence of any name change and proof of your citizenship. Please ensure you include a postal address, your personal phone number
and personal email address, as well as your Agent’s details (if applicable), so that the University can contact you if required.

PROPOSED STUDY PROGRAM

To ascertain which staff member has an interest in your field of proposed research please visit the www.research.swinburne.edu.au website or contact
the faculties directly.
You must provide a Statement of Purpose of not more than 300 words outlining your reason for undertaking this program. A full explanation is on page 3 of this
application form.

ENGLISH LANGUAGE PROFICIENCY

If you have completed an IELTS, TOEFL, Swinburne English for Academic Purposes (EAP) Level 5 program no more than two years ago, please attach certified copies
of the test results, EAP Academic Purposes Advanced Level Certificate, academic transcript or testamur. If you have obtained a degree taught in the English language
no more than five years ago, please attach certified copies of the academic transcripts and testamur. Further information regarding Swinburne’s English language
requirements can be obtained at www.international.swinburne.edu.au/entry-requirements/english

RESEARCH PROPOSAL
If your research is being supported by an organisation external to Swinburne University of Technology, you may be required to sign a ‘Deed of Assignment’ prior to
commencing your research project. Further information regarding the University’s Intellectual Property Policy is available at: www.swinburne.edu.au/intellectual-property

SUPERVISION
It is essential that you make contact with a potential supervisor before submitting this application to enable you to nominate a principal coordinating academic
supervisor and associate supervisor on this application form. If you do not nominate your potential principal coordinating academic supervisor, then this application will
be processed as an initial research enquiry. The Higher Degrees Research Committee will only consider those applications that are supported by a Supervisor/s and
Faculty. You should consult with your proposed supervisor/s and obtain signatures in the ‘For Completion by Supervisors’ section of this form. If you are submitting this
application form from overseas, you must attach email confirmation from your supervisor/s.

SCHOLARSHIPS
If you are applying for a Swinburne-funded scholarship, you must have met all English language requirements at the time of application.

ACADEMIC BACKGROUND
You must provide certified copies of your academic transcripts for all qualifications and if your academic transcripts are in a language other than English, you must
also attach an English translation, certified by the Registrar of the issuing institution or by an accredited translator. Photocopies of previously certified documents are
not acceptable. Please ensure that you attach a current curriculum vitae.

REFEREES
You must provide details of at least two people to whom confidential reference may be made by Swinburne. These people should have current professional knowledge
of your academic ability and be able to judge your research potential. In an application for PhD or Professional Doctorate candidature, one of these referees must be
external to Swinburne.

CHECKLIST AND DECLARATION

After completing the application form, read through the checklist to ensure you have provided all required information and documentation.
Please note: The Honours equivalence section [Pg 5] is for completion by Supervisors and may be completed after the application is submitted.

PAGE 1 OF 11 Swinburne University of Technology

International student Representative/agent stamp

Application for admission to Higher Degree

by Research Candidature and Scholarship (if applicable)

If you are a permanent resident, or a citizen of Australia or New Zealand you cannot apply using this
form. You must apply using the domestic student application form.

PERSONAL DETAILS

If previously enrolled at Swinburne University of Technology, please state your Swinburne ID number:

Are you a Swinburne staff member? Yes No If yes, please provide your Swinburne Staff ID Number:

Date of birth: D D / M M / Y Y I identify my gender as: Female Male Prefer not to answer

Title (Mrs, Miss, Ms, Mr, Mx etc):

Family name:
(as indicated in passport)

Given names:
(leave spaces between names)

If you have changed your name, give your previous name:

Email address:
(for applicant) APPLICANTS MUST PROVIDE THEIR PERSONAL EMAIL ADDRESS.
ALL COMMUNICATIONS/INFORMATION REGARDING THE PROGRESS OF THE APPLICATION WILL BE EMAILED DIRECTLY TO THE APPLICANT.

Postal address:
Number/street

Suburb/city

Country Postcode

Residential address:
(Fill out only if different to Number/street
postal address. Residential
address should not be the
same as your agent.)
Suburb/city

Country Postcode

Telephone: Mobile:

Country of citizenship: Submission location:

(What country were you in when you submitted this application?)

Country of birth: Do you hold a valid Australian visa? Yes No

If yes, type of visa: Visa expiry date: D D / M M / Y Y

Have you ever had a visa application rejected? Yes No

If yes, when, which country and for what reason? Please provide a copy of the rejection letter or details below:

PAGE 2 OF 11 Swinburne University of Technology

 PERSONAL DETAILS (CONTINUED)

Have you visited or studied in Australia previously? Yes No Have you breached any visa conditions? Yes No
Have you ever been refused a visa for entry into Australia? Yes No If yes, please provide reason:

Please provide details of family immigration history.

Are you married? Yes No Date of marriage: D D / M M / Y Y Please provide a certified copy of your marriage certificate.
Is your spouse already in Australia? Yes No
What visa does your spouse hold?
What is the expiry date of your spouse’s visa?
Please provide details on all dependents who will be included in your student visa application, including their date of birth.

Name: Date of birth: D D / M M / Y Y

Name: Date of birth: D D / M M / Y Y

Name: Date of birth: D D / M M / Y Y

Name: Date of birth: D D / M M / Y Y

If you have more than four dependents, please attach a separate sheet with any remaining dependents details.
Have you been convicted of any criminal activity? Yes No If yes, please provide relevant details:

Do you have a disability, impairment or long term medical condition? Yes No

Tick one or more of the following
Hearing/Deaf Intellectual Mobility Learning Visual Mental Illness Medical Condition
Providing information about a disability or medical condition will not disadvantage your application. However the University needs to assess if it can make reasonable
adjustments to accommodate your disability or medical condition in order to advise you appropriately. In some cases the support required may be at a cost to you.
Do you have a medical or health-related issue that may prevent a student visa being issued? Yes No
Please refer to www.immi.gov.au/allforms/health-requirements/meeting-health-req.htm

If yes, please provide details:

PROPOSED STUDY PROGRAM

Which research program are you applying for? To check program code refer to www.international.swinburne.edu.au/courses

PROGRAM CODE PROGRAM NAME CAMPUS INTENDED COMMENCEMENT

e.g. DR-SCI, MR-HAS e.g. Doctor of Philosophy, Master by Research e.g. Hawthorn Month Year

Please attach a Statement of Purpose (not more than 300 words) detailing reasons for undertaking this course of study, reasons for choosing Australia rather than
your home country, relevance of this course to your academic and/or employment background and relevance of this course to your future career/educational plans.
Please also provide evidence of your economic circumstances in your home country and evidence of significant ties to your home country.
Please note that due to Swinburne’s obligations under Australian migration, trade and sanction laws, even if you meet Swinburne’s academic entry and selection
criteria, it is possible that Swinburne may not be able to offer you a place due to additional non-academic criteria required to meet Swinburne’s legal requirements,
which are applied at Swinburne’s sole discretion. For further information please see:
(1) Migration Act 1958 (Cwth)
(2) Migration Regulations 1994 (Cwth)
(3) Autonomous Sanctions Act 2011 (Cwth)
(4) Autonomous Sanctions Regulation 2011 (Cwth)
Refer to www.immi.gov.au
Refer to www.dfat.gov.au

PAGE 3 OF 11 Swinburne University of Technology

 PROPOSED STUDY PROGRAM (CONTINUED)

Please note:
■■ The actual start date is the day on which you enrol. We do not recommend that you commence your candidature in December.
■■ Please allow up to six months for the processing of your student visa application

Applying for research component of a Professional Doctorate in Design

If applying for the research component of a Professional Doctorate in Design what was your commencement date in the program? D D / M M / Y Y

Prior contact with the Faculty/School/Department

It is essential that you indicate which academic staff member in your area of proposed research you have had contact with.
Have you contacted the relevant academic Faculty? Yes No
If yes, please provide the name of the person(s) you would like to nominate as your potential academic supervisor(s):

Name: Faculty:
If no, then this application will now be referred to the most appropriate Faculty/School/Department as a research enquiry to ascertain if a suitable academic
supervisor can be identified and you will be informed via email.

ENGLISH LANGUAGE PROFICIENCY

Is English your first language? Yes No

If no, what is your first language?

If no, have you taken an English proficiency test within the last 2 years? Yes No Date of test: D D / M M / Y Y

If yes, please attach a certified copy of your results, or submit a certified copy as soon as possible.

Test type: Result:

(e.g. IELTS/TOEFL) (if known)

Do you intend to sit for an IELTS or TOEFL test? Yes No If yes, please indicate approximate date of test: D D / M M / Y Y

Do you intend to undertake English language studies (ELICOS) at Swinburne? Yes No If yes, approximate start date: D D / M M / Y Y

Number of ELICOS weeks: 5 10 15 20 25 30 40 50 Other:

IELTS Exam Preparation (10 weeks)? Yes No If yes, please advise approximate start date: D D / M M / Y Y

Please tick this box if you have successfully completed a total of 24 months (full time equivalent) of formal study where the language of instruction and
assessment was English at AQF level 7 or above (or equivalent) at an approved university. These studies need to have been completed within the last five years.

Please note: if you are applying for a Swinburne-funded scholarship, you must have met all English language requirements at the time of application.

RESEARCH PROPOSAL

Title of research proposal:

Please attach a brief description of your project. As a guide the description may include background of the research problem, proposed research method, an overview
of the initial literature of the research problem, possible limitations, the contribution to knowledge that this project will potentially make.
Please note: Different faculties may have different requirements. Please check with your faculty before submitting your application.
Are there any essential/special requirements required to undertake this research? Yes No
If yes, what is required?

Where will the research work be conducted?

Internally (i.e. at Swinburne)
Externally. Please name the organisation/s and provide the address/es:

Combination of both internal and external. Please state where the majority of the research will be carried out:

If your research is being supported by an organisation external to Swinburne (e.g. APAI, CRC, Industry Scholarship), have you signed a ‘Deed of Assignment’? Yes No
If you have not signed a ‘Deed of Assignment’ you may be required to do so prior to commencing your project. The Deed of Assignment is a formal contract between
the candidate and the University and is tied to the formal contract between the University and the funding body that covers issues pertaining to the ownership of
Intellectual Property. Where an external body that is providing funds for the research holds a contract with the University you are not permitted to commence your
candidature until you and the University have signed a ‘Deed of Assignment’. For further information please check with your proposed principal coordinating supervisor.
The University’s Intellectual Property Policy is available at www.swinburne.edu.au/corporate/registrar/ppd/docs/IntellectualPropertyPolicy.pdf

PAGE 4 OF 11 Swinburne University of Technology

 RESEARCH PROPOSAL (CONTINUED)
Please indicate the examination mode requested. In consultation with the nominated supervisory panel, students may select a standard examination process, in
which the examinable outcome is dispatched to a minimum of two external examiners invited by the Higher Degrees Research Committee to examine the submitted
works. Examiners are asked to make a recommendation to the Swinburne Higher Degrees Research Committee and classify the work. Alternatively, students may
select an oral examination process, in which the examiners engage in a face-to-face discussion (real or virtual) with the candidate with the purpose of obtaining
responses to questions raised by their reading of the work, after reading the examinable outcome, and prior to making their recommendations.
Standard Examination Process
Oral Examination (Viva Voce) Process

SUPERVISION

Please nominate a principal coordinating supervisor:

Please nominate an associate supervisor:

You may have further supervisors if appropriate

Name of 3rd supervisor (optional):

Name of 4th supervisor (optional):

Have you spoken with the above-named supervisors about your intended project? Yes No

Please note: you cannot submit your application without agreement to supervise from at least one academic supervisor.

FOR COMPLETION BY SUPERVISORS

■■ Before you agree to supervise an applicant you must be approved to the ‘Register of Accredited Supervisors’. You should also read the Higher Degrees by Research
Policy and Procedure at www.swinburne.edu.au/policies/research/index.html
■■ The maximum supervisory load for a Principal Coordinating or Coordinating supervisor is 7 EFTSL (i.e. 7 full-time candidates or equivalent) and the maximum
supervisory load for an associate supervisor is 7 EFTSL, with a maximum of 15 persons to be supervised by any one supervisor at a time, in any supervisory role.
■■ If there are more than four members of the proposed supervisory team, please attach extra copies of this page.

Honours Equivalence
In my opinion, the academic results achieved by this student are at least equivalent to an Australian Honours program at level (please tick):
H1 (80–100) H2A (70–79)
This assessment is based in the following ground/s (please tick one or more, as appropriate):
 he applicant’s academic standing and qualifications.
T
The results obtained in the previous course of study can be considered equivalent to an Australian Honours result of H1 or H2A; or the previous course of study
can be considered to be equivalent to, or higher than, an Australian Honours program (i.e. a Masters by Research).
 he duration of the previous tertiary program completed.
T
The program was at least four years in duration.
 utstanding academic results with identifiable research potential.
O
The applicant’s results are clearly equivalent to an H1 or H2A and the student has obvious research potential, based on their previous studies and/or work experience.
 he quality of the applicant’s previous tertiary institution.
T
The previous tertiary institution attended is included in the Shanghai Jiatong or the “Academic Ranking of World Universities” Top 500 Universities.
 vidence of capacity for independent research shown by the applicant.
E
The applicant has previously completed a minor/major thesis, or undertaken a significant research project in their professional career.
 he applicant’s other relevant previous research experience, such as:
T
– the applicant has previously undertaken, and successfully completed, a research subject(s)
– the applicant has previously completed a Bachelor or Masters thesis
– the applicant has written one or more quality of research publications (particularly journals and books)
– the applicant has completed special research projects which were undertaken within a professional environment
Please provide a detailed explanation as to how the boxes checked above demonstrate equivalence for this student:
For example, “The student’s previous tertiary program was four years in duration, and the student obtained an average result of 83% in the final year”.

I understand that by signing below I am not guaranteeing the future performance of this student but I am confirming that, in my opinion, the qualifications
that this applicant, and the results they have achieved in their previous study, satisfy the minimum entry requirements of the University.

Signature of Principal Coordinating Supervisor: Date: D D / M M / Y Y

PAGE 5 OF 11 Swinburne University of Technology

Principal Coordinating Supervisor
I agree to be the principal coordinating supervisor for: (Applicant’s name)
I am approved by the Swinburne Higher Degrees Research Committee to supervise at this level and I have read the Higher Degree by Research Policy and Procedures
and the Statement of Supervisory Practice.
Register checked
Current supervisory load (number of students):

At Principal Coordinating / Coordinating level: Full-time: Part-time: At Associate level: Full-time: Part-time:

Name: Title: Present position:

Email: Swinburne Internal Mail Number:

Telephone: Faculty or External address:

Signature: Date: D D / M M / Y Y

Have you attended any workshops on research supervisory practice in the last 12 months? Yes No

Coordinating Supervisor
I agree to be the coordinating supervisor for: (Applicant’s name)
I am approved by the Swinburne Higher Degrees Research Committee to supervise at this level and I have read the Higher Degree by Research Policy and Procedures
and the Statement of Supervisory Practice.
Register checked
Current supervisory load (number of students):

At Principal Coordinating / Coordinating level: Full-time: Part-time: At Associate level: Full-time: Part-time:

Name: Title: Present position:

Email: Swinburne Internal Mail Number:

Telephone: Faculty or External address:

Signature: Date: D D / M M / Y Y

Have you attended any workshops on research supervisory practice in the last 12 months? Yes No

Associate Supervisor 1
I agree to be the associate supervisor for: (Applicant’s name)
I am approved by the Swinburne Higher Degrees Research Committee to supervise at this level and I have read the Higher Degree by Research Policy and Procedures
and the Statement of Supervisory Practice.
Register checked
Current supervisory load (number of students):

At Principal Coordinating / Coordinating level: Full-time: Part-time: At Associate level: Full-time: Part-time:

Name: Title: Present position:

Email: Swinburne Internal Mail Number:

Telephone: Faculty or External address:

Signature: Date: D D / M M / Y Y

Have you attended any workshops on research supervisory practice in the last 12 months? Yes No

Associate Supervisor 2
I agree to be the associate supervisor for: (Applicant’s name)
I am approved by the Swinburne Higher Degrees Research Committee to supervise at this level and I have read the Higher Degree by Research Policy and Procedures
and the Statement of Supervisory Practice.
Register checked
Current supervisory load (number of students):

At Principal Coordinating / Coordinating level: Full-time: Part-time: At Associate level: Full-time: Part-time:

Name: Title: Present position:

Email: Swinburne Internal Mail Number:

Telephone: Faculty or External address:

Signature: Date: D D / M M / Y Y

Have you attended any workshops on research supervisory practice in the last 12 months? Yes No

PAGE 6 OF 11 Swinburne University of Technology

 ETHICS APPROVAL

Please discuss with your proposed supervisor prior to completion of this section.
Does your project involve any of the following (please tick):
Human Research (e.g. various activity with or about people or their data, personal belongings or tissue)
Care and use of live animals
Genetically Modified Organisms (GMO)
None of the above – please proceed to Scholarships section of this form
If your research does involve any of the above, it will require ethics approval from either the Human Research Ethics Committee (HREC) or the Animal Experimentation
Ethics Committee (AEEC). Application forms are available from the Secretary, HREC/AEEC, telephone 613 9214 8468 or 613 9214 5218 or facsimile 613 9214 5267 or
www.research.swinburne.edu.au/ethics
Do you have ethics clearance from or on behalf of either the Swinburne’s Human Research Ethics Committee (SUHREC) and/or the Animal Experimentation Ethics
Committee (AEEC) and/or Institutional Biosafety Committee (SUIBC)?
Yes No
If yes, please provide certificate number given to your application: Date approval was obtained: D D / M M / Y Y

SCHOLARSHIPS

1. Research scholarships
(a) Have you been awarded a scholarship to undertake your research? Yes No

(b) If yes, please indicate the name and type of scholarship:

2. Applying for a scholarship

(a) Notes
■■ Information on scholarships offered and a detailed guide to each scholarship is available on the web at www.swinburne.edu.au/research/schols.htm
■■ Completion of the following section of the form signifies that you wish to be considered for a scholarship during the next scholarship round which opens in
either April or September. It is your responsibility to ensure that referee reports are forwarded to your referees and returned in time to be considered during the
scholarship round.
■■ Offer of candidature is not dependent on the award of a scholarship.
■■ If you are already enrolled in a research program, please contact Swinburne Research on (03) 9214 5547.
■■ Your scholarship application will only be considered if all the required documents are provided.
■■ Scholarships are normally awarded only for full-time study and awarded to our top doctoral students based on a meritorious assessment.

(b) Scholarships for which you are applying:

Chancellor’s Research Scholarship
Vice-Chancellor’s International Scholarship
International Postgraduate Research Scholarship (IPRS)
Swinburne University Postgraduate Research Award (SUPRA)
Tuition Fee Scholarship
Other. Please specify: 

Have you been awarded an external scholarship to undertake your research? Yes No

If yes, please state name and type of scholarship:

3. Referee reports
If you are applying for a scholarship in one of the Swinburne scholarship rounds or you are receiving a scholarship through your faculty or nominated supervisor,
you are also required to send a copy of the full Referee Report Form (available at: www.swinburne.edu.au/research/research-degrees/application-process/
submit-application/) to each of your referees. Referee reports must be returned to Swinburne Research by the application closing date of the scholarship for which
you are applying.
Note: If your application for a scholarship is not successful, you will be notified by the University. At this point you may be invited to apply for candidature only, or to
have your application considered in the next scholarship round.

PAGE 7 OF 11 Swinburne University of Technology

 ACADEMIC BACKGROUND

List all courses in which you have been enrolled at tertiary institutions. Attach certified academic transcripts for each course.

TITLE OF PROGRAM AWARDING INSTITUTION PERIOD OF ENROLMENT COMPLETION DATE HONOURS LEVEL LANGUAGE OF INSTRUCTION
(e.g. MSc) (e.g. Swinburne University of Technology) (e.g. 2010–2012) (e.g. 2012 or “not completed”) (e.g. H1, H2A) (e.g. English)

PRIOR RESEARCH

1. Did any of the completed degrees above include a research component? Yes No
If yes:
(a) What percentage of the degree was research? Please provide evidence:

(b) Please provide a brief summary of that research (attach further documentation if required):

(c) Have you undertaken any additional research or has any of your work been published? Yes No
If yes, please list (attach further documentation if required):

2. Are you transferring from another Australian university or have you previously been enrolled in a research degree at another Australian university? Yes No
If yes:
(a) Name of university:

(b) What was your candidature commencement date? D D / M M / Y Y

(c) Have you withdrawn your candidature? Yes No Have you completed your candidature? Yes No

If yes, please indicate date of completion/withdrawal: D D / M M / Y Y

If you have not yet completed/withdrawn from your program, any candidature offer made to you will be conditional on you providing evidence that you have
completed/withdrawn prior to your enrolment at Swinburne.

3. Have you previously been excluded or suspended from Swinburne or any other educational institution for academic or non-academic reasons? Yes No

If yes, institution and reason:

RELEVANT EMPLOYMENT HISTORY AND/OR RESEARCH EXPERIENCE

EMPLOYER NATURE OF WORK START DATE END DATE FULL-TIME

OR PART-TIME

PAGE 8 OF 11 Swinburne University of Technology

 REFEREES

Please provide details of at least two people to whom confidential reference may be made by Swinburne. These people should have current professional knowledge
of your academic ability and be able to judge your research potential. In an application for PhD or Professional Doctorate candidature, one of these referees must be
external to Swinburne.

REFEREE ONE REFEREE TWO

Name

Position

Address

Daytime phone

Mobile phone

Email address

Referee reports
If you are applying for a scholarship in one of the Swinburne scholarship rounds or you are receiving a scholarship through your faculty or nominated supervisor,
you are also required to send a copy of the full Referee Report Form (available at: www.swinburne.edu.au/research/research-degrees/application-process/
submit-application/) to each of your referees. Referee reports must be returned to Swinburne Research by the application closing date of the scholarship for which
you are applying.

LIVING COSTS
Please visit the following website for a guide to living costs: www.international.swinburne.edu.au/plan-your-arrival/living-in-melbourne/living-expenses
Please visit the following website for a guide to tuition fees: www.international.swinburne.edu.au/study-at-swinburne/tuition-fees
Do you understand the costs associated with studying in Australia? Yes No
(including the cost of tuition, living expenses, overseas student health cover and return airfares etc.)

How will you fund your study and living costs? Choose more than one if applicable.

Self-funded Sponsored by family/government/institution/employer Bank loan Other (e.g. employer)

Please read and complete the following CHECKLIST and the DECLARATION on the next page.

CHECKLIST
Check that you have:
Completed and signed the application form
Answered all questions
Nominated two academic referees
Contacted an Academic Supervisor/s and obtained relevant signatures or attached email confirmation
Kept a copy of the application for your records

Check that you have attached copies of the following:

Translated documentation (if original documents are in a language other than English)
Summary of Research Proposal
Details of awards or achievements
Details of research experience
List of academic publications
A copy of your curriculum vitae outlining details of any relevant research and/or professional experience
Evidence of English language proficiency
Academic transcript/s (including key to results)
Evidence of Completion of previous academic programs
Copy of passport (photo page and relevant visa page if applicable)
Statement of Purpose
Certified copy of your marriage certificate if applicable
Please ensure that documentation is certified as a true and correct copy of the original by either the issuing body or by those people qualified to accept a statutory
declaration (e.g. police, pharmacist, doctors, accountants). Do not submit original documents.

PAGE 9 OF 11 Swinburne University of Technology

DECLARATION

Applicant’s declaration
1. I declare that the information submitted with this application is true and complete. I further declare that any tertiary academic results submitted are a complete
record of all results I have obtained from every tertiary institution I have attended.
2. I acknowledge that failure to disclose my academic record may result in the University revoking an offer or terminating my studies at any stage.
3. I authorise the University to seek verification of my academic and professional qualifications, and work experience. I understand that the University reserves
the right to inform other tertiary institutions and regulatory agencies if any of the material presented to support my application is found to be false.
4. I understand that at the time of enrolment I will be required to supply originals of all documents used to support this application.
5. I acknowledge that the University reserves the right to alter any course, subject, admission requirement or fee without prior notice.
6. I understand that the personal information I have provided may be released to government agencies as required by law. I further understand that it may
be disclosed to third parties for the purpose of progressing my application.
7. I acknowledge that I have read and understand the description of the program/s that I am applying for on Swinburne’s website.
8. I authorise the University to access the Australian immigration Visa Entitlements Verification Online (VEVO) system at any time to obtain information
on my visa status.
9. I declare that I am a genuine temporary entrant and genuine student and that I have read and understood conditions relating to requirements outlined on
www.immi.gov.au
10. I am aware of the tuition and living costs of my stay in Australia and have the financial capacity to meet such costs for the duration of my course.
I will make timely payments of any fees or associated costs.
11. I declare that my signature is true and correct and matches the signature in my passport.

Declaration by applicant
I (insert full name) ,
understand all of the requirements for the course and visa application and confirm that all of the information provided is true.

Signature of applicant: (as in passport signature page): Date: D D / M M / Y Y

Agent’s declaration (if applicable)

1. I have assessed the applicant and to the best of my knowledge the applicant is a genuine temporary entrant and genuine student as defined by DIAC and I confirm
the documents and information provided by the applicant did not disclose any conclusive grounds for rejecting the applicant’s declarations that they are a genuine
temporary entrant and a genuine student.
2. To the best of my knowledge, the applicant is genuine in making this application and has every intention of completing all programs listed in the application.
3. The documents which form part of this application appear to be authentic and valid. To the best of my knowledge the applicant has genuine access to the total
funds required, while in Australia, to cover all travel, OSHC, tuition and living costs for themselves and their family members (if applicable).
4. I recommend the University proceed with the assessment for admission of this applicant.
5. I confirm the student has signed this application form.
6. I have provided the student’s personal email address and residential address, as disclosed to me by the student.

Agency name:

Agency branch office:

Agent staff member name:

Signature of Agent: Date: D D / M M / Y Y

SENDING YOUR APPLICATION

Please send your application to:
Postal address Or, in person
Swinburne University of Technology Student HQ
Swinburne International (on any campus)
PO Box 218
Hawthorn VIC 3122 Or, by email
Australia [email protected]

Please note: the maximum file size for electronically submitting this application to [email protected] is 10MB. If your application is larger than this
maximum file size, you will receive a delivery failure email notice and you will need to resize or split your application into more than one email and resend.

Or deliver your application in person to:

Student HQ
(on any campus)
Note: Do not submit this application direct to your Faculty or Supervisor.

PAGE 10 OF 11 Swinburne University of Technology

OFFICE USE ONLY

ASSOCIATE DEAN, RESEARCH AND ENGAGEMENT APPROVAL

1. Please mark the category used to establish eligibility for candidature.
(Please ensure that evidence of eligibility, including equivalence, is provided with the application).
Master by Research Master by Coursework 4 year Bachelor Degree with Honours 1 or 2A or equivalent
Other postgraduate qualifications Other relevant tertiary qualification Other relevant experience

2. Are essential resources that are required to complete the applicant’s research project available? Yes No
If No, please provide details of essential requirements and when they are expected to be available:

3. Does the Faculty have sufficient depth of expertise in the appropriate area to cover a situation
where the current supervisory team is no longer available? Yes No

4. Is the applicant required to undertake any preliminary studies? Yes No

If Yes, please provide details of required preliminary studies:

5. Will the applicant be awarded a Faculty/Industry scholarship to undertake the research? Yes No

6. If the applicant has applied for an IPRS, Chancellor’s Research Scholarship or SUPRA do you wish
to support the scholarship application? Yes No

7. Are you requesting a Tuition Fee Scholarship without stipend? Yes No

If Yes, please complete and attach the Tuition Fee Scholarship application form.

Checklist – Prior to approving this application:

Consider information contained within the applicant’s referee reports
Ensure that current supervisory load limits are adhered to prior to approving the application

The student and supervisory panel have agreed to the following mode of examination:
Standard Examination Process Oral Examination (Viva Voce) Process

The Faculty Higher Degrees Research Committee recommends the applicant for admission to candidature:

Program Code: Unit of Study Code/s:

Circle one: By Thesis By Exegesis By Papers

Centre/Department:

Name of Associate Dean, Research and Engagement:

Signature: Date: D D / M M / Y Y

HIGHER DEGREES RESEARCH COMMITTEE APPROVAL

Authorised by Chair, Higher Degree Research Committee

Signature: Date: D D / M M / Y Y

Outcome: Admitted Conditional Rejected Pending Deferred

Conditions/Reasons:

CRICOS Provider code: 00111D

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