Expression of Interest Form (Domestic)

Version: 2.3 | Responsibility: Admissions and Administration Department | Last Reviewed: September 2020

Campus Location:

Melbourne

Hobart

Personal Details

Family/Last name: *

(as stated in your passport)

Given/First Name *

Date of Birth *

Student must be at least 18 years of age at the time of arrival in Australia

Gender: *

Female

Male

Other

Languages spoken at home:

First Language:

Address

Street Address *

City

State

Country

Postal code

Mailing Address (if different):

Street address
Suburb
State
Postcode
Telephone
Mobile
Fax
E-mail

Do you have any disabilities or medical conditions? *

No

Yes

If 'Yes', please specify:

Will it impact your ability to study?

Yes

No

Do you have a Unique Student Identifier (USI) number? *

Yes

No

USI Number:

No, please select:

I will create myself (www.usi.gov.au)

I authorise RGIT Australia to create/retain/retrieve on my behalf

Do you have a Victorian Student Number (VSN)? *

No – I have not attended a Victorian school since 2009 or a TAFE or other VET training provider since 2011

Yes – I have attended a Victorian School since 2009

And/or Yes – I have participated in training at a TAFE or other training organisation since the beginning of 2011 (List up to 3 training organisations)

Enter your VSN Number (provided to you by most recent Victorian School/TAFE attended):

Most recent school attended:

Please list up to 3 training organisations

Course of Study

Please list the course/s you are applying for to study at RGIT Australia:

Please include the CRICOS Code, Name of the Course, Course Duration, and the Proposed Commencement Date

Reason for Choosing this Course

Please select the reason for choosing this course:

If other, please specify:

If an agent/consultant referred you – my referring agent/consultant is:

English Language Proficiency

Please select which of the following applies to you. Attach relevant evidences/ documentation to support your selections.

English is my first language.

I have completed a recognised English language test.

I intend to complete an ELICOS course in Australia.

English was the language of instruction in my secondary/tertiary studies.

Other

Please make sure you refer to the specific entry requirements that apply to the course you are applying for. These requirements are detailed in the student prospectus. From 1 July 2018, students applying for HLT54115 Diploma of Nursing, would be required by the NMBA to provide a formal English language skills test when applying for registration and must provide a formal English language test result demonstrating achievement of the NMBA specified level of English language skills, prior to commencing the program (www.nursingmidwiferyboard.gov.au).

Name of the test (e.g. IELTS, TOEFL):

Test score:

Other

Document Upload:

Education History

Please provide details and documentation of your past education including the highest qualification reached or completed.

Employment History

Please provide details and documents of your relevant employment. Attach a separate page if necessary.

Employment History Documents:

Media Consent

From time to time, RGIT Australia staff may request to take photographs/videos or verbal/written interviews/testimonials of students at RGIT or at places where the student is involved in an activity. These creations may be used in a classroom or on-the-job work activities or could be published by RGIT in print, digital or broadcast media such as documents, student magazine, website, RGIT TV, newsletters, displays, journals, professional development materials for trainers and marketing collateral. Staff may also at times request students provide any of the above of the students’ own creation for the same purposes.

Media Consent:

I do not consent to RGIT Australia using any of the above materials involving me for the purposes outlined above.

Student Declaration

I confirm that I have read and understood RGIT Australia’s current Student Prospectus or information provided on RGIT Australia’s website (www.rgit.edu.au), which includes details and information about the course entry requirements, English entry requirements, Language, Literacy and Numeracy (LLN) requirements, and other important information about the course(s) I am applying for. I also understand the Fees Payment and Refund Policy, including an explanation of what occurs, if for some unforeseen reason, the course is not delivered.

I confirm that I am fully aware of the Fees Payment and Refund Policy, conditions of enrolment and privacy statement as set out in RGIT Australia's Privacy Policy and Procedure, available at www.rgit.edu.au/policies, which I agree to abide by as a student at RGIT Australia.

I understand that I am not required to pay more than the initial tuition fee amount as stated on the letter of offer before the start of the course.

I declare that all information provided in this expression of interest is complete and correct. I understand that failure to provide correct information or documentation in relation to this expression of interest may result in the cancellation of my enrolment.

Signature of Student: *

Clear

Signature of Parent or Legal guardian:

Clear

Note: This expression of interest and declaration must be signed by a parent or legal guardian if the student is under 18 years of age at the time of expression of interest.

Sign Date: *