STUDENT REGISTRATION FORM

Please attach recent

passport photo of
applicant
PHILIPPINES
INSTRUCTIONS
1. Please write clearly in English and in CAPITAL LETTERS:
2. Please fully complete the Personal Information & Contact Details section.
3. Please return completed form to IDP Reception
Personal Information IDP ID No.

Title (please tick box): Miss Mrs Mr Dr Other (please specify)

Family Name: _________________________________________________________________________________________________________
First Name: ______________________________________________ Preferred Name (Nickname): ____________________________________
Birthdate (day/month/year): ________________________________ Marital Status: ________________________________________________
How did you first hear about IDP? Advertisement Exhibition IELTS
IDP visit to my institution Australian Embassy IDP - Website
Australian Institution Website IDP - Marketing materials Other (Please specify):
Referral Social Media (FB, Twitter, Instagram, etc)
o Friends/Family IDP - Article
o IDP Employee
o My employer
Contact Details

Mobile: _________________________________________________ Landline: ____________________________________________________

Email: __________________________________________________ Other Email: _________________________________________________
Mailing Address:
____________________________________________________________________________________________________________________

Citizenship Details

Country of Birth: __________________________________________ Country of Residence: __________________________________________

Examinations
Have you taken the IELTS, TOEFL, SAT, GRE, GMAT, etc? Yes (Test taken: ______________________ ) No
If yes, Date Taken (day/month/year): _________________________ Overall Score: ________________________________________________

Education Profile

Highest Level of Study: _____________________________________ Institution: ___________________________________________________

Country: ________________________________________________ Course Name: ________________________________________________
Study Start Date: (day/month/year): __________________________ Study End Date (day/month/year): _______________________________
Was course completed? Yes No Have you completed a licensure examination? ______________________

Work Experience (Current or Most Recent Employment)

Job Title: ________________________________________________ Location: ____________________________________________________

Employer: _______________________________________________ Part Time? Yes No
Key responsibilities: ____________________________________________________________________________________________________
Start Date: (month/year): __________________ End Date (month/year): ___________________ Duration: _____________________________

Student Interest

How can we help you? Study Visa Other: ____________________________________________________

When do you intend to start your studies?
Intake Year: 2016 2017 2018 2019 2020
Intake Month: Dec March April Aug Sep Nov
Where do you want to go?
Australia USA UK NZ Canada
Preferred City/State: ___________________
Who is sponsoring your application?
Parents Relatives Self-funding
Have Scholarship Needs Scholarship Dont Know
Preferred Level of Study: _______________________________________ Preferred Subject Area: _____________________________________
 In-Office Terms, Conditions and Consents
Welcome to IDP and thank you for choosing us to help you achieve your goals of studying abroad. Our aim is to properly assist you with the right information to
get started. Being the business globally for over 40 years, you can be assured that we extend quality service to our student clients.

We offer to supply our services to you based on the terms and conditions contained in this document. We also need your consent to do certain things on your
behalf, and to pass on information you give us to certain people or organizations for the reasons we explain below. Please read the following carefully, and if you
agree with what we have asked, please sign and date this form below. Thank you and you have taken the first step to global education.

1. Who we are and what we do

IDP is a global company that promotes overseas education in local markets. We do this in a variety of ways, including assisting students with their
applications to various international education institutions.

2. What we ask you to do

(a)You agree that
(i) all information you supply will be complete, accurate and truthful;
(ii) any essay questions or other written statements you need to do as part of any application process will be completed by you alone;
(iii) you will directly notify both IDP and the academic institution you are applying to immediately should any information you give cease to
be complete, accurate and truthful;
(iv) you will only use our system for the purpose of assisting you with your application to study. This includes not doing anything to
interfere with the functioning of our system or anyone elses application within the system; and
(b) You acknowledge that you are solely responsible for the completeness, accuracy and truthfulness of all information that you give us.
(c) If you are offered and accept a place on a course, you undertake to obey the Rules, Regulations, Statutes and Ordinances of the academic institution, and to
ensure the payment of all fees and other liabilities for the course you apply for. You understand that you are solely responsible for paying any applicable fees or
other liabilities involved in applying to or undertaking the courses you choose and, in particular, that we cannot be responsible for any changes to course or fee
details.

3. Your Privacy
(a) Your privacy is respected by us. Personal information such as your address and contact details will only be provided to the following people for the purposes
specified:
(i) To the academic institutions you have nominated, to enable your application for entry to be considered by those academic institutions;
and
(ii) To those academic institutions referred to in 3(a)(i), or to other organizations such as Immigration Departments or individual research
workers for statistical or research purposes, but only in an anonymous form so that you cannot be individually identified.

4. Acceptance
I understand that IDP Education Pty Limited (IDP) collects the above personal information (possibly including information defined as sensitive
information by privacy protection legislation). I understand that the purpose for collecting the information is to enable my request for obtaining
information on study opportunities overseas and for applying to study at international institutions via IDP to be processed. I understand that I will be
able to have reasonable access to this information and to request correction of any information that I believe is inaccurate. I understand that IDP also
takes reasonable steps to ensure the security of my personal information. I understand that IDP will disclose my personal information only to
organisations or individuals who are directly and immediately involved in activities associated with the purpose for which this information is being
collected. I understand that IDP may wish to notify me of future events/promotions/exhibitions and other updates from IDP regarding international
education. I also understand that IDP may use my personal information to undertake research for the purpose of international education.

I consent to IDP collecting my personal information (including sensitive information) for the purpose of processing my
enquiry/application to study.
I consent to IDP notifying me of future events/promotions/exhibitions or other updates regarding international education.
I consent to IDP using my personal information to undertake research for the purpose of international education

____________________________ ________________________
Signature over printed name Date (day/month/year)
of student or guardian

Please do not write below this line

For office use only

Counsellor: ______________________________________________________ Offer Letter already available?
Campaign Source: _____________________________________________________ No (Full Processing) Yes (Partial Processing)
Proposed Start: _______________________________________________________________________________________________________
Preferred Level of Study: ___________________________________________ Preferred State/Location: ______________________________
Preferred Subject Area: _________________________________________________________________________________________________

st
Institution: 1 Preference: ________________________________________________________________________________________
nd
2 Preference: _______________________________________________________________________________________
rd
3 Preference: ________________________________________________________________________________________

Comments: __________________________________________________________________________________________________________