Attach with this application the following documents:

-A copy of your Confirmation of Enrolment (eCOE)

-A copy of CERTIFIED PASSPORT (by notary public or commission of oath)
-A copy of Personal Statement of why you want to study abroad
-Other documents will be required for students under 18 and families after lodgement and will be at the discretion of your case
officer including but not limited financials, GTE statement , visa history and your personal circumstances.

APPLICANT CONTEXT
Kindly write in CAPITAL letters and CIRCLE all answers.

CURRENTLOCATION
Give details of the applicant’s current location:

Current Location AUSTRALIA / OTHERS(please specify)

Legal Status CITIZEN / OTHERS(please specify)

CONFIRMATIONOF ENROLMENT
Does the applicant hold a Confirmation of Enrolment(CoE) for any intended course of study in Australia?
**Please fill in eCoE number

YES

OTHER EVIDENCEOFINTENDEDSTUDY
Does the applicant holds evidence of their intended study in Australia other than a CoE?

NO

EDUCATIONS ECTOR

HIGHER EDUCATION/OTHERS(please specify)

CLOSURE OF EDUCATION PROVIDER

Is application applying for this visa due to the closure of their education provider?
NO

COMMONWEALTHFUNDEDSTUDENT
Is the applicant receiving partial of full funding under a training scheme approved by the Commonwealth government of Australia?

Yes/No

YOUR PERSONAL DETAILS

Enter the following details as they appear in the applicant’s passport.

Family Name

Given Name

Gender Male/Female/ Others

Date of Birth

Passport Number

Country of Passport CHINA / OTHERS(please specify)

Nationality of Passport CHINA / OTHERS(please specify)

Date of Issue

Date of Expiry

Place of Issue

(It is recommend that the passport be valid for atleast six months)

-Page1-
 YOURPLACEOFBIRTH

Town/City

State/Province

Country of Birth CHINA / OTHERS(please specify)

Relationship Status Never Married/ Married/ Divorced/ Engaged /Separated /DeFacto

OTHER NAMES/SPELLINGS
Is this applicant currently, or have they been ever known by any other names?
**If yes, please specify

Yes/No
CITIZENSHIP
Is this applicant a citizen of the country of passport?
**If no, please specify
Yes/No

Is this applicant a citizen of any other country?

**If yes, please specify

Yes/No
Does this applicant have other current passports?
**If yes, please specify

Yes/No
Does this applicant have national identity documents?

YES NATIONAL IDENTITY DOCUMENT(I.E Passport/Identification Card)

Please provide the document type, card number, issue country info, issue date, and expiry date

Has this applicant previously travelled to Australia or previously applied for a visa?

Yes/No If yes, please specify visa applied date and purpose

Health examination
Has this applicant undertaken a health examination for an Australian visa in the last 12 months?
Yes, please provide the HAP, medical centre, and day information.
No

ACCOMPANYINGFAMILYMEMBERS
Are there any accompanying family members included in this application?

Yes/No
**If NO, please PROCEED TOFOLLOWINGQUESTION**If YES, please specify the below details:-

ALL ACCOMPANYING FAMILYHAS TOBEINCLUDED–I.E child, husband, wife

(Kindly specify all field answered for no for the below details)

Relationship to the primary applicant Spouse/Child/ De Facto

Does the family member have a current passport? Yes/No

Is this family member currently, or have they been ever known by any other names? Yes/No

Is this family member a citizen of the country of passport? Yes/No

Is this family member a citizen of any other country? Yes/No

Does this family member have other current passport? Yes/No

Does this family member have national identity passport? Yes/No

Does this applicant have national identity documents? Yes/No

-Page2-
DEPARTMENT OFFICE
The applicant may be required to attend an Australian Government Office for an interview.
Which is the closest office to the applicant’s current location?

Nearest Australian Commission Location MELBOURNE / OTHERS(please specify)

Usual Country of Residence CHINA/OTHERS(please specify)

RESIDENTIALADDRESSDETAILS
Note that a street address is required. A post office address cannot be accepted as a residential address.

HOME COUNTRY

Country CHINA / OTHERS(please specify)

Address

Suburb/Town

Postal Code

Contact Telephone Numbers in Usual Country of Residence

Business Phone

Home Phone

Mobile/Cell Phone

RESIDENTIALADRESSINAUSTRALIA(IFKNOWN)

Country AUSTRALIA

Address

Suburb/Town

Postal Code

Contact Telephone Numbers in Australia

Home Phone

Mobile/Cell Phone

POSTALADDRESSFORCORRESPONDENCE
Is the postal address for correspondence the same as the applicant residential address in their usual country of residence?

Yes/No

**If NO, please specify the below details:-

Country

Address

Suburb/Town

Postal Code

Contact Telephone Numbers in Usual Country of Residence

Mobile/Cell Phone

-Page3-
AUTHORISEDRECIPIENT
Does the applicant authorize another person to receive written correspondence on their behalf?

This authorizes the department to send the authorized person all written correspondence that would otherwise be sent directly to
the applicant.

NO

ELECTRONICCOMMUNICATION
All correspondence relating to this application will be sent to the email address below

YES(COMPULSORY) enter e-mail address

NON-ACCOMPANYINGFAMILYMEMBERS
Details of ALL members of applicant’s family unit MUST BE INCLUDED in this application whether or not they intend to for a
Student visa. If non-accompanying family unit member’s details are not included in this application, they will not be eligible for
grant of a student visa at a later date.

Are there any non-accompanying family members included in this application?

Yes/No

**If NO, please PROCEED TOFOLLOWING QUESTION**If YES,please specify the below details:-

ALLNON-ACCOMPANYING FAMILY MEMBERS HAS TOBE INCLUDED–I.E child, husband, wife

(Kindly specify all field answered for no for the below details)

Relationship to the primary applicant Spouse/Child/ De Facto

Does the family member have a current passport? Yes/No

Is this family member currently, or have they been ever known by any other names? Yes/No

Is this family member a citizen of the country of passport? Yes/No

Is this family member a citizen of any other country? Yes/No

Does this family member have other current passport? Yes/No

Does this family member have national identity passport? Yes/No

Does this applicant have national identity documents? Yes/No

Relationship to the primary applicant Spouse/Child/ De Facto

Does the family member have a current passport? Yes/No

Is this family member currently, or have they been ever known by any other names? Yes/No

Is this family member a citizen of the country of passport? Yes/No

Is this family member a citizen of any other country? Yes/No

Does this family member have other current passport? Yes/No

Does this family member have national identity passport? Yes/No

Does this applicant have national identity documents? Yes/No

-Page4-
OTHERFAMILYMEMBERS
Doestheapplicanthaveanyparentsorsibling inoroutsideofAustralia?

YES(COMPULSORY) ALLFAMILY MEMBERS HAVETOBEINCLUDED**Pleasefillinthebelowfield

Relationshiptoapplicant Parent/Brother/Sister/Step Brother/Step Sister

Familyname

Givenname

Gender Male/Female

DateofBirth

UsualcountryofResidence CHINA / OTHERS(pleasespecify)

Relationshiptoapplicant Parent/Brother/Sister/Step Brother/Step Sister

Familyname

Givenname

Gender Male/Female

DateofBirth

UsualcountryofResidence CHINA / OTHERS(pleasespecify)

Relationshiptoapplicant Parent/Brother/Sister/Step Brother/Step Sister

Familyname

Givenname

Gender Male/Female

DateofBirth

UsualcountryofResidence CHINA / OTHERS(pleasespecify)

Relationshiptoapplicant Parent/Brother/Sister/Step Brother/Step Sister

Familyname

Givenname

Gender Male/Female

DateofBirth

UsualcountryofResidence CHINA / OTHERS(pleasespecify)

-Page5-
GENUINETEMPORARYENTRANT
Allstudentvisaapplicantsarerequiredtoprovideinformationinsupport oftheirapplicationtodemonstratethattheymeetthe
Genuine TemporaryEntrant(GTE)criteria.

The statement should include:

 Your reasons for choosing to undertake the course of study specified in your application;
 Your reasons for choosing your education provider;
 Your reasons for choosing to study in Australia rather than in your home country;
 The relevance of your course of studies to your academic and/or employment background; and
 The relevance of the course to your future career/educational plans.

FUNDINGFORSTAY
Doallapplicantsinthisapplication confirmthattheyeachhaveaccesstosufficient fundstosupportthemselvesforthetotal
periodofstayinAustraliaandunderstandthatfurtherevidenceoffundsmayalsoberequested?

YES

Fundssupportedby Parents /GovernmentSponsorship/BankLoan/Self

Funding type Deposit / Bank Loan / Ongoing income / other

Approximate value in Australian Dollars (AUD) ____________________

(12 month of tuition, living ($19830) and travel costs)

If Choose Deposit in Financial institution

Name of financial institution ___________________________________

HEALTHINSURANCE
DoestheapplicanthaveOverseas StudentHealthCover(OSHC)?

YES

Was theOverseasStudentHealthCoverarranged bytheapplicant’seducationprovider?

Yes/No

Nameof HealthInsurer(statedinthe CoE)

InsurancePolicy Number(ifknown)

Datefrom

Dateto

EDUCATION
Highestlevel ofschooling(i.e.A-levels)

Coursename

Institutionname

CountryofInstitution CHINA / OTHERS OUTSIDE AUSTRALIA(pleasespecify)

Has theapplicant completed,oriscurrentlyenrolledinanyotherstudiesortrainingoutside Australia?

Yes/No

Has theapplicant previouslystudiedinAustralia?

Yes/No
-Page6-
EMPLOYMENT HISTORYDETAILS
Employment Status STUDENT/OTHERS(pleasespecify)

Isthisyourcurrentemployment situation? YES

Previous Coursename /Workdesignation

Institutionname /Company

Datefrom

LANGUAGE
Has theapplicantundertakenanEnglishlanguagetestwithinthelast 24months?

Yes/No

Mainlanguage

English /Malay/Mandarin /Tamil/Others(pleasespecify)

Has theapplicant successfullycompletedatleastfiveyearsofstudies(intheEnglishLanguage) inAustralia,Canada,NewZealand, Republic

ofSouthAfrica,RepublicofIreland,UnitedKingdom,and/orUnited StatesofAmerica?

Yes/No

Intwoyearsbeforeapplyingthe studentvisa, hastheapplicantsuccessfullycompletedtherequirementsforaSeniorSecondary

Certificate ofEducation(conductedinEnglishinAustralia)?

Yes/No

Inthetwoyearsbeforeapplyingforthestudentvisa, hastheapplicantsuccessfullycompletedasubstantialcomponentofa
courseleading toaqualificationfrom the Australian QualifiedFrameworkatCertificate IV orhigherasholderofastudentvisa
)conducted inEnglishinAustralia)?

Yes/No

COUNTRIES VISITED
Haveanyoftheapplicantsvisitedanycountriesinthepast 10years?

Yes/No

Include:

Workorstudyoutsideyourusual countryof residence

Holiday/leisuretrips
Business
Militarydevelopment
Visitsbacktoyourusual countryof residenceiflivingaway

**Ifyes,pleasefillinthe below
Nameofcountry _ Nameofcountry Nameofcountry

Datefrom Datefrom Datefrom

Dateto Dateto Dateto

Reasonofvisit Reasonofvisit Reasonofvisit

-Page7-
VISAHISTORY
Has theapplicant,oranypersonincluded inthisapplication,heldorcurrentlyholdavisatoAustralia oranyothercountry?

Yes/No

Has theapplicant,oranypersonincluded inthisapplication,everbeeninAustralia oranyothercountryandnotcompiledwith

visaconditionsordepartedoutsidetheirauthorisedperiodofstay?

Yes/No

Has theapplicant,oranypersonincluded inthisapplication,everhadanapplicationforentry orfurtherstayinAustralia orany

othercountryrefused, orhadavisacancelation?

Yes/No

HEALTHDECLARATION
Inthelastfiveyears, hasanyapplicantvisited,orlived outsidetheircountry ofpassport, formorethan3consecutivemonths?
DonotincludetimespentinAustralia.

Yes/No

Doesanyapplicantintendtoenterahospitalorahealthcarefacility (includingnursinghomes)whileinAustralia?

Yes/No

Doesanyapplicantintendtoworkas, orstudytobedoctor,dentist,nurseorparamedic duringtheirstayinAustralia?

Yes/No

Doesanyapplicantintendtoworkorbeatrainee atachildcarecentre(including preschoolsandcrèches)whileinAustralia?

Yes/No

Has anyapplicant:

Everhad,orcurrentlyhave,tuberculosis?
Beeninclosecontact withafamilymember thathasactivetuberculosis?
Everhadachest x-raywhich showedanabnormality?

Yes/No

DuringtheirproposedvisittoAustralia,doesanyapplicantexpectto incurmedicalcosts,orrequiredtreatment ormedicalfollow for:

Bloodcondition
Cancer
Heartdisease
HepatitisB orCand/orliverdisease
HIVinfection, includingAIDS
Kidneydisease,includingdialysis
Mentalillness
Pregnancy
Respiratorydiseasethathasrequiredhospitaladmissionor oxygentherapy
Others?

Yes/No

Doesanyapplicantrequireassistancewithmobilityorcaredueto medical condition?

Yes/No

-Page8-
CHARACTER DECLARTIONS
Has anyapplicant everbeenchargedwithanyoffencethatcurrentlyawaiting legalaction?

Yes/No

Has anyapplicant everbeenconvictedofanoffenceinanycountry(includinganyconviction whichisnowremovedfromofficial records?

Yes/No

Has anyapplicant everbeenthe subjectifanarrestwarrantorInterpol notice?

Yes/No

Has anyapplicant everbeeneverbeenfoundguiltyofasexuallybasedoffenceinvolving achild(includingwherenoconviction was

recorded?

Yes/No

Has anyapplicant everbeennamedonasexoffender register?

Yes/No

Has anyapplicant everbeenacquitted ofanyoffenceonthegroundsofunsoundnessofmindofinsanity?

Yes/No

Has anyapplicant everbeenfoundbyacourt notfittoplead?

Yes/No

Has anyapplicant everbeendirectly orindirectly involvedin,orassociatedwith,activitieswhichwouldrepresentarisktoa

nationalsecurityinAustralia oranyothercountry?

Yes/No

Has anyapplicant everbeen chargedwith, orindicatedfor;genocide, warcrime,crimesagainsthumanity,torture,slavery, orany

othercrimethatisotherwiseofaserious internationalconcern?

Yes/No

Has anyapplicant everbeenassociatedwithaperson, groupororganisationthathasbeenorisinvolvedincriminalconduct?

Yes/No

Has anyapplicant everbeenassociatedwithanorganisationengagedinviolence orengagedinactsofviolence(includingwar,

insurgency,freedomfighting,terrorism,protest)eitheroverseas orinAustralia?

Yes/No

Has anyapplicanteverservedina militaryforce,police force,statesponsored/privatemilitiaorintelligenceagency(including

secretpolice)?

Yes/No

Has anyapplicant everundergoneanymilitary/paramilitarytraining,beentrainedinweapons/explosivesorinthemanufacture

ofchemical/biologicalproducts?

Yes/No

Has anyapplicant everbeen involvedinpeople smugglingorpeopletraffickingoffences?

Yes/No

-Page9-
Has anyapplicant everbeenremoved, deportedorexcludedfrom anycountry(includingAustralia)?

Yes/No

Has anyapplicant everbeenoverstayedavisainanycountry(includingAustralia)?

Yes/No

Has anyapplicant everhadanyoutstandingdebtstotheAustralianGovernmentoranypublic authorityAustralia?

Yes/No

STUDENTDECLARTIONS
Warning: Giving falseormisleading informationis aseriousoffence.

Theapplicantsdeclarethatthey:

Havereadandunderstoodtheinformationprovidedonthewebsite(www.studyinaustralia.gov.au)regardingliving andstudying
inAustralia.

Yes/No

Haveaccesstosufficient fundstosupportthemselvesforthetotalperiodofstayinAustralia.Theyalsounderstandthattheymay
berequestedtoprovidefurtherevidenceoffunds.

Yes/No

Havemadeadequatearrangementstohealth insurancefortheperiodoftheirstayinAustraliaandacknowledgetheyarerequired to
maintainthesearrangementswhileinAustraliaastheholderofastudentvisa.

Yes/No

Understandthatastudentvisaisatemporaryvisaandthatbeinggrantedastudentvisawill notguaranteethattheywillbe
eligibleforthegrantofafurthervisatostayinAustralia,includingaskilledmigrationvisa.

Yes/No

Understandthatiftheycannotobtainafurther visatheymustdepartAustralia onorbeforetheceasedateofthe studentvisa.

Yes/No

Acknowledgethatifgrantedastudentvisa, theyarerequiredtounderstandandabidebyits conditions.

Yes/No

Understandthatifthe8534visacondition isimposedonthestudentvisa,itwill beindicatedbythecondition code 8534condition

hasbeenimposedontheirvisaandwhileinAustraliatheywill onlybeentitledtothegrant ofthelimitedvisasincluding:

Asubclass485(Temporary Graduate)visa, or
Asubclass590(StudentGuardian)visa

Yes/No

Understandthattheeffect of 8534visaconditionisthatitwill notbepossibletoapplyto remaininAustraliabeyondthedateof

authorisedonthe studentvisaandthattheywill berequiredtodepartAustralia onorbeforethatdate.

Yes/No

-Page10-
Understandthatifthe8535visacondition isimposedonthestudentvisa,itwill beindicatedbythecondition code 8535andby
theshortdescriptionNoFurtherStay.Theyacknowledgedthatthismeans thatthe8535 conditionhas beenimposedontheirvisa
andwhileinAustraliatheywillonlybeentitledtothegrantoflimitedvisas including:

 A furtherstudentvisa(subclass500)incircumstance wheretheCommonwealth,orforeigngovernment(as thecase

required), doesnotopposethem from obtainingafurthervisatostayinAustralia.

Yes/No

DECLARATIONS
Warning: Giving falseormisleading informationis aseriousoffence.

Theapplicantsdeclarethatthey:

Havereadandunderstoodtheinformationprovidedtotheminthisapplication.

Yes/No

Haveprovidedcompleteandcorrect informationineverydetail onthisform, andonanyattachmentstoit.

Yes/No

Understandthatifanyfraudulentdocumentsorfalseormisleading informationhasbeenprovidedwiththisapplication,orifany
oftheapplicantsfail tosatisfytheMinister oftheiridentity,theapplicationmayberefusedandtheapplicant(s),andanymember
oftheirfamilyunit,maybecomeunabletobegrantedavisaforaspecifiedperiodoftime.

Yes/No

Understandthatifdocumentsarefoundtobefraudulentorinformationtobeincorrectafterthegrantofavisa, thevisa may

subsequentlybecancelled.

Yes/No

Understandthatifthisapplicationisapproved, anypersonnotincluded inthisapplicationwillnothaveautomatic rightofentryto

Australia

Yes/No

Will inform theDepartment ofImmigrationandBorderProtectioninwritingimmediatelyas theybecomeawareofachangein

circumstances(including change ofaddress)orifthereisanychangerelatingtoinformationtheyhaveprovidedinorwiththis
application,whileitisbeingconsidered.

Yes/No

HavereadtheinformationcontainedinthePrivacyNotice (Form 1442i).

Yes/No

Understandthatthedepartmentmaycollect,useanddisclosetheapplicant'spersonalinformation(includingbiometric
informationandother sensitiveinformation)as outlinedinthePrivacyNotice (Form 1442i).

Yes/No

Giveconsenttothecollectionoftheirfingerprintsandfacialimage.

Yes/No

Understandthat,ifrequiredtoprovidetheirfingerprintsandfacialimage,theapplicant'sfingerprintsandfacialimageand biographical
informationheldbytheDepartmentofImmigrationandBorderProtection maybegiventoAustralianlaw
enforcementagenciestohelpidentifytheapplicant anddetermineeligibility forgrant ofthevisabeingappliedfor, andforlaw
enforcementpurposes.

Yes/No

-Page11-
GiveconsenttoAustralianlawenforcementagenciesdisclosingtheapplicant'sbiometric,biographical andcriminal record
informationtotheDepartment ofImmigrationandBorder Protectiontohelpidentifytheapplicant,todetermineeligibilityfor grant
ofavisaandforlawenforcementpurposes.

Yes/No

GiveconsenttotheDepartmentofImmigrationandBorderProtectionusingtheapplicant'sbiometric,biographical andcriminal
recordinformationobtainedforthepurposesoftheMigrationAct 1958orthe CitizenshipAct2007.

Yes/No

AUSTRALIAVALUES
Allpersonsincludedinthisapplicationwhoare18yearsorover haveread, orhadexplainedtothem,informationprovidedbythe
AustralianGovernmentonAustraliansocietyandvaluesandagreestothe Australianvaluesstatement. Yes

Yes/No

Secret Questions and Answers: Please choose at least 5 and cannot use the same answer.
(Or, send us the immi account and password if you have already created)

1、 Where were you born?

2、 What is your location of work?

3、 Name your favorite holiday destination.

4、 What was your first job?

5、 What is the name of your favorite teacher?

6、 What is your favorite animal?

7、 What is the name of your favorite sports team?

8、 What is your mother’s maiden name?

9、 What is your favorite color?

10、 What is your favorite movie?

11、 Who is your favorite author?

12、 Who is your favorite athlete?

PAYMENT DETAILS– AUD$575

(asurcharge ofcreditcardusage willbe charged
for Master Card or Visa Card, or higher for other card)
Howwillyoupayyourapplicationcharge?
(Ifapplyingin Australia,debitorcreditcardisthe preferredmethod)

Creditcarddetails

MastercardVisaAmericanExpressJCBDinersCreditcardnumber

---Expirydate
-
CVV(3 digitnobehindthe card) 
Cardholdername

-Page12-
Telephone

Signatureofcardholder

-Page13-
 TOBEREADANDACKNOWLEDGEDBY STUDENT /GUARDIAN
 Pleasecheckthecompletedapplicationformthoroughlyandreporttousifthereisany
inaccurateormissinginformation.WeWILLNOTBEHELDRESPONSIBLEforanyerrors aftervisa
hasbeen lodged.

Pleaseundergo yourmedicaltestswithinthe next 24-48 hours. (after submission of visa)

Ifyouare unwell,kindlycheckwiththe doctorasyour visa canbe rejectedifyouexceedthe deadline for
submittingyourmedicalreports.

 Hub International Davaowillassistandsupportonthevisaprocessing,buttheapprovalissubjecttothe

decisionmadeby
AustralianGovernmentDepartmentofImmigrationandBorderProtection(Australianimmigration
)

ItishighlyrecommendedparentsDO NOTconfirmthe flightuntilthe visa isobtained.

Howdo Ifindoutwhatisthe processingstatusofmyapplication?

Logonto the websiteat: https://online.immi.gov.au/lusc/loginandenteryour “ImmiAccountlogin
and password”. The login detailswillbesharedtoyoubyyour counsellor afteryour visa hasbeen
lodged.

 Who do Icontactif Iexperienceanyproblemswithmyapplicationafterithasbeenlodged on the

system?
Youwillneedto provide thevisahelpdeskwithdetailsofthe difficultiesyouare experiencing.Youmust provide
name andyour visa referencenumber(EGO12346L).

E-Visa StudentsHelpdeskat thisemailaddress: wa.evisa.students.helpdesk@border.gov.au.

 Can the ImmigrationOffice atthe AustralianHighCommission inPhilippines assistme

withstudente-Visa enquiry?
No,the ImmigrationOffice at the AustralianHighCommissioninPhilippines isunable toassist with student e –
Visa enquiriesasthe applicationisprocessedinPerth.Please direct your queryto the e -Visa
helpdeskthroughemail.

Howdo I know when mystudente-Visa applicationhasbeen approved?

Bylogging onto theinternet, you can findout whenyour student e-Visa applicationhasbeenapproved and
granted.Visa grant notificatione-mailwillbesent to students once itisfinalized.

Do I getavisa labelinmy passportasproofthatmystudente-Visa hasbeen granted?

No,your visa willbe anelectronicvisa andnoevidencewillbe providedinyour passport.

IMPORTANT:
Allstudentvisashavecondition8202attached tothem.Condition 8202stipulatesthat studentsmust
attendaminimum of80% oftheirclassesandmaintainasatisfactoryperformancerecord.Ifcondition
code8202isbreachedtheeducation institutionwillreportthe studenttoDIACforconsideration of
cancellationoftheirstudentvisa.Studentswhose visasarecancelledforbreachofconditionaresubject to a three-
yearexclusion periodfrom Australia.

PLEASENOTETHATIDPWILLNOTBERESPONSIBLEORLIABLEFORANY PROBLEMSOR
DELAYINTHEPROCESSINGORGRANTOFASTUDENTVISA.IF THEVISAHAPPENS TOBE
GRANTEDAFTERACOURSEHASBEGUN,STUDENTSMAYHAVETOREAPPLYFORANEW VISAIF
THEEDUCATIONPROVIDER REFUSES TO ACCEPTTHEMFOR THATPARTICULAR INTAKE.VISA
FEESARE ABSOLUTELY NONREFUNDABLE.

WEACKNOWLEDGETHATALL MATTERSMENTIONEDABOVEARE CLEARLYUNDERSTOOD.

Student Name: Signature/Date:

GuardianName: Signature/Date:

-Page14-