Application Form Home > Application Form STUDENT DETAILS (Please attach a certified copy of your Passport)Family Name*Given Name(s)English Name (if any)Nationality*Date of Birth (day/month/year)* DD slash MM slash YYYY Passport Number*Mobile number*Gender (shown on your passport)*Address Within Australia Outside Australia Address*Address Line 2Address Line 3City*State*Post Code*Country*AddressPost Code*State*ACTNSWNTQLDSATASVICWAEmail* Copy of Passport*Max. file size: 12 MB.COURSESStart Date* DD slash MM slash YYYY Total Duration*Preferred Course* PTE Examination Preparation IELTS Examination Preparation YOUR LEARNING GOALSWhy do you wish to study PTE and IELTS Examination Preparation? (What is your learning goal? Please explain.What is your desired score in PTE or/and IELTS exams?SPECIAL NEEDSDo you need accommodations for special needs, such as those related to hearing or visual impairment? If yes, please briefly explain here.PROOF OF ENGLISH (Please attach the certified copy of IELTS, PTE or equivalent examination results (if any)Do you currently have a valid proof of English?* Yes No Certified copy of IELTS, PTE or equivalent examination results*Max. file size: 12 MB.VISADo you have a valid visa to study in Australia?* Yes No Are you going to apply for a student visa in Australia or outside of Australia?* In Australia Outside of Australia Copy of Student Visa*Max. file size: 12 MB.OVERSEAS STUDENT HEALTH COVERDo you currently have Overseas Student Health Cover (OSHC)?*(Eg. Medibank, Bupa, Allianz, etc.) Yes No Copy Of Overseas Student Health Cover (OSHC)*Max. file size: 12 MB.When does it expire?* DD slash MM slash YYYY And who is your insurer?*Would you like EnglishWise Global to arrange your OSHC?* Yes No AGENCY INFORMATION (If applicable)Name of agencyContact PersonEmail Contact NumberAPPLICATION ACKNOWLEDGEMENT AND AGREEMENTI acknowledge and agree that: The information provided in this application form to study at EnglishWise Global is accurate to my knowledge, Should my learning goals not align with the course offered by EnglishWise Global, the application may not be accepted, and An offer made to me will be subject to the terms and conditions set out in the Offer Letter. Student's Signature*Date* DD slash MM slash YYYY
