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You can apply online instead of using this application form? To apply online please visit:

Please note: Pursuant to obligations under the ESOS Act 2000 and the National Code, the University of South Australia may make available any information provided in this form to Australian federal and State agencies. In particular, the University is required to inform the Department of Immigration and Citizenship (DIAC) about certain changes regarding a students enrolment and any breach of a students visa conditions related to attendance or unsatisfactory academic performance.

Application No:

For office use only

University of South Australia

Please print clearly and neatly using BLOCK letters to enable accurate processing of your application. (All sections MUST be completed).

International application form

1. Personal details
Mr Mrs Miss Ms Dr Female Male Given Names Family Name Do you want your Family name to appear rst on all ofcial UniSA documents e.g. Transcripts/Parchments? Date of Birth Citizenship/NationaIity Do you have Australian permanent residency status? Visa No Have you studied at UniSA before? Do you have a disability or long-term illness? Do you require disability support services? Yes Yes Yes No No No Yes No / / (day/month/year; example: 16/January/1980) Country of birth Yes



What is your preferred rst name?


Do you currently hold a temporary Australian Visa? Visa date from If yes, provide Student ID If yes, please provide details



Visa date to

2. Address details
Permanent address in home country (Note: do not use PO box numbers) No. and Street Suburb/City State/Country Telephone My mailing address is different from my home address No. and Street Suburb/City State/Country Telephone Fax Zip/Postcode Email Mobile Fax I am currently living in Australia Zip/Postcode Email Mobile

Please advise UniSA International if you change your address during the year.

3. English language prociency (All students must complete this section)

Is English your rst language? Yes No If no, what is your rst language? Yes No Have you studied at secondary or tertiary levels with English as the language of instruction? (for example, Foundation Studies, etc) If you are enrolled or are planning to enrol in English Language studies, give details below: Date of course commencement (day/month/year) IELTS overall score (academic) Subscores: Listening / TOEFL overall score Reading / Level Other English language test Writing Institution Test date Speaking

4. Program preferences (Please list your program preferences in order of priority)

Program Name 1. * 2. 3. Program Code ( ( ( Year Study Period 4 (Jun) Part-time Specialisation (if applicable) ) ) )

*Your rst preference will be processed rst. Second and third preferences will be processed only if your rst choice is unsuccessful. Commencement of program

Study Period 1 (Jan) Study Period 5 (Jul) Study in South Australia

Study Period 2 (Feb) Study Period 6 (Sep) External Study in home country

Study Period 3 (Apr) Study Period 7 (Oct) For External students only: Full-time

Please note: Many Postgraduate Research, Health Sciences and MBA applications require the completion of an additional, specialist application form. For further details and application forms:

MBA Health Sciences Research apply online at

5. Financial support
Please indicate your source of nancial support and for invoice purposes please attach information of person or organisation paying fees. I am fully sponsored by my home government (attach documentation) I am fully sponsored by my employer (attach documentation) I will apply for nancial aid from my government, my employer or the Australian Government I am a private student supported by myself/my family I am fully sponsored by an Australian Government Scholarship Name of Sponsor

6. Academic records
Please provide certified copies of all appropriate academic documentation in both English and original languages.

7. Secondary studies
Name of school Language of instruction Years From Mth Name of school certicate / Yr To Mth / Yr Completed? Yes No*

8. Tertiary/Higher Education studies

Name of institution Language of instruction Name of institution Language of instruction Name of institution Language of instruction Years From Mth Years From Mth Years From Mth Name of award/qualication / Yr To Mth / Yr Completed? Yes No*

Name of award/qualication / Yr To Mth / Yr Completed? Yes No*

Name of award/qualication / Yr To Mth / Yr Completed? Yes No*

*If no, are you intending to complete studies prior to commencing at UniSA?



9. Credit/Advanced Standing
Do you wish to have your already completed tertiary level studies to be considered for credit/advanced standing?* Yes No *If yes you must attach detailed syllabuses (curricula) of courses you have completed. An application for credit/advanced standing cannot be assessed without this information.

10. Professional employment/experience

Present position Date of service From Previous position (if any) Date of service From To To Employers Full-time Employers Full-time Part-time Part-time

11. Checklist (Please ensure you have:)

Completed all relevant sections of this application. Attached or forwarded certified copies of your IELTS/TOEFL results. Indicated your program preference. Attached any relevant financial support documentation as requested in question 5.

Attached certied copies of your qualications and academic transcripts. Please do not send original documents. Attached detailed syllabuses if you answered yes to question 9. Attached your professional resume/CV if you completed question 10 . Signed the declaration.

A certified copy is a copy of the original document that has been certified by an official such as a UniSA agent, UniSA staff member, Justice of the Peace, Notary Public, police officer or examining authority.

12. Declaration
I declare that, to the best of my knowledge, the information provided by me is true and complete in every particular. I acknowledge that the University of South Australia may vary or reverse any decision regarding admission or enrolment made on the basis of incorrect or incomplete information provided by me. I understand that I am seeking temporary entry into Australia for educational purposes only. I authorise the University of South Australia to make enquiries about the details associated with this application. I understand the above conditions and am prepared to accept them in full. In particular, I understand that I, or my sponsor, will be responsible for the full costs of the program for which I am seeking admission, as well as the attendant travel and living costs. I also understand that the University of South Australia will not provide a subsidy to me for any costs incurred in the use of campus child care facilities for my dependants, and that I must pay full fees for any school-aged dependants enrolled in government or non-government schools.
I acknowledge that the documents submitted for my application become the property of the University of South Australia. If I do not meet the entry requirements for the program I have applied for, I agree that I can be considered for entry to an alternative program at UniSA or have my application forwarded to the pathway college, the South Australian Institute of Business and Technology . (SAIBT), as appropriate.

Representatives/agent stamp



Return this form with supporting documentation to: UniSA International, University of South Australia, GPO Box 2471, Adelaide, SA 5001, AUSTRALIA

CRICOS Provider Number: 00121B