Enrolment Application Form 1 Personal 2 Contact 3 Education 4 Other 5 Course 6 Documents 7 Personal Details Title Mr Ms Miss Mrs Please Select Title Gender Male Female Other Please Select Gender Family Name Please Enter Family Name First Name Please Enter First Name Middle Name (Optional) Please Enter Middle Name Date of Birth Please Enter Day Please Enter Month Please Enter Year Country of Citizenship None Selected 1101 Australia 1102 Norfolk Island 1201 New Zealand 1301 New Caledonia 1302 Papua New Guinea 1303 Solomon Islands 1304 Vanuatu 1401 Guam 1402 Kiribati 1403 Marshall Islands 1404 Micronesia, Federated States of 1405 Nauru 1406 Northern Ireland 1406 Northern Mariana Islands 1407 Palau 1501 Cook Islands 1502 Fiji 1503 French Polynesia 1504 Niue 1505 Samoa 1506 Samoa, American 1507 Tokelau 1508 Tonga 1511 Tuvalu 1512 Wallis and Futuna 1513 Pitcairn Islands 2102 England 2103 Isle of Man 2105 Scotland 2106 Wales 2107 Guernsey 2108 Jersey 2201 Ireland 2301 Austria 2302 Belgium 2303 France 2304 Germany 2305 Liechtenstein 2306 Luxembourg 2307 Monaco 2308 Netherlands 2311 Switzerland 2401 Denmark 2402 Faroe Islands 2403 Finland 2404 Greenland 2405 Iceland 2406 Norway 2407 Sweden 2408 Aland Islands 3101 Andorra 3102 Gibraltar 3103 Holy See 3104 Italy 3105 Malta 3106 Portugal 3107 San Marino 3108 Spain 3201 Albania 3202 Bosnia and Herzegovina 3203 Bulgaria 3204 Croatia 3205 Cyprus 3206 Former Yugoslav Republic of Macedonia (FYROM) 3207 Greece 3211 Romania 3212 Slovenia 3214 Montenegro 3215 Serbia 3301 Belarus 3302 Czech Republic 3303 Estonia 3304 Hungary 3305 Latvia 3306 Lithuania 3307 Poland 3308 Russian Federation 3311 Slovakia 3312 Ukraine 4101 Algeria 4102 Egypt 4103 Libya 4104 Morocco 4105 Sudan 4106 Tunisia 4107 Western Sahara 4111 South Sudan 4201 Bahrain 4203 Iran 4204 Iraq 4205 Israel 4206 Jordan 4207 Kuwait 4211 Oman 4212 Qatar 4213 Saudi Arabia 4214 Syria 4215 Turkey 4216 United Arab Emirates 4217 Yemen 5101 Burma (Myanmar) 5102 Cambodia 5103 Laos 5104 Thailand 5105 Viet Nam 5201 Brunei Darussalam 5202 Indonesia 5203 Malaysia 5204 Philippines 5205 Singapore 5206 East Timor 6101 China (excludes SARs and Taiwan) 6102 Hong Kong (SAR of China) 6104 Mongolia 6105 Taiwan 6201 Japan 6202 Korea, Democratic People's Republic of (North) 6203 Korea, Republic of (South) 7101 Bangladesh 7102 Bhutan 7103 India 7104 Maldives 7105 Nepal 7106 Pakistan 7107 Sri Lanka 7201 Afghanistan 7202 Armenia 7203 Azerbaijan 7204 Georgia 7205 Kazakhstan 7206 Kyrgyzstan 7207 Tajikistan 7208 Turkmenistan 7211 Uzbekistan 8101 Bermuda 8102 Canada 8103 St Pierre and Miquelon 8104 United States of America 8201 Argentina 8202 Bolivia 8203 Brazil 8204 Chile 8205 Colombia 8206 Ecuador 8207 Falkland Islands 8208 French Guiana 8211 Guyana 8212 Paraguay 8213 Peru 8214 Suriname 8215 Uruguay 8216 Venezuela 8299 South America, nec 8301 Belize 8302 Costa Rica 8303 El Salvador 8304 Guatemala 8305 Honduras 8306 Mexico 8307 Nicaragua 8308 Panama 8401 Anguilla 8402 Antigua and Barbuda 8403 Aruba 8404 Bahamas 8405 Barbados 8406 Cayman Islands 8407 Cuba 8408 Dominica 8411 Dominican Republic 8412 Grenada 8413 Guadeloupe 8414 Haiti 8415 Jamaica 8416 Martinique 8417 Montserrat 8421 Puerto Rico 8422 St Kitts and Nevis 8423 St Lucia 8424 St Vincent and the Grenadines 8425 Trinidad and Tobago 8426 Turks and Caicos Islands 8427 Virgin Islands, British 8428 Virgin Islands, United States 8431 St Barthelemy 8432 St Martin 9101 Benin 9102 Burkina Faso 9103 Cameroon 9104 Cape Verde 9105 Central African Republic 9106 Chad 9107 Congo 9108 Congo, Democratic Republic of 9111 Cote d'Ivoire 9112 Equatorial Guinea 9113 Gabon 9114 Gambia 9115 Ghana 9116 Guinea 9117 Guinea Bissau 9118 Liberia 9121 Mali 9122 Mauritania 9123 Niger 9124 Nigeria 9125 Sao Tome and Principe 9126 Senegal 9127 Sierra Leone 9128 Togo 9201 Angola 9202 Botswana 9203 Burundi 9204 Comoros 9205 Djibouti 9206 Eritrea 9207 Ethiopia 9208 Kenya 9211 Lesotho 9212 Madagascar 9213 Malawi 9214 Mauritius 9215 Mayotte 9216 Mozambique 9217 Namibia 9218 Reunion 9221 Rwanda 9222 St Helena 9223 Seychelles 9224 Somalia 9225 South Africa 9226 Swaziland 9227 Tanzania 9228 Uganda 9231 Zambia 9232 Zimbabwe Lebanon Moldova Please Enter Country of Citizenship Country of Birth None Selected 1101 Australia 1102 Norfolk Island 1201 New Zealand 1301 New Caledonia 1302 Papua New Guinea 1303 Solomon Islands 1304 Vanuatu 1401 Guam 1402 Kiribati 1403 Marshall Islands 1404 Micronesia, Federated States of 1405 Nauru 1406 Northern Ireland 1406 Northern Mariana Islands 1407 Palau 1501 Cook Islands 1502 Fiji 1503 French Polynesia 1504 Niue 1505 Samoa 1506 Samoa, American 1507 Tokelau 1508 Tonga 1511 Tuvalu 1512 Wallis and Futuna 1513 Pitcairn Islands 2102 England 2103 Isle of Man 2105 Scotland 2106 Wales 2107 Guernsey 2108 Jersey 2201 Ireland 2301 Austria 2302 Belgium 2303 France 2304 Germany 2305 Liechtenstein 2306 Luxembourg 2307 Monaco 2308 Netherlands 2311 Switzerland 2401 Denmark 2402 Faroe Islands 2403 Finland 2404 Greenland 2405 Iceland 2406 Norway 2407 Sweden 2408 Aland Islands 3101 Andorra 3102 Gibraltar 3103 Holy See 3104 Italy 3105 Malta 3106 Portugal 3107 San Marino 3108 Spain 3201 Albania 3202 Bosnia and Herzegovina 3203 Bulgaria 3204 Croatia 3205 Cyprus 3206 Former Yugoslav Republic of Macedonia (FYROM) 3207 Greece 3211 Romania 3212 Slovenia 3214 Montenegro 3215 Serbia 3301 Belarus 3302 Czech Republic 3303 Estonia 3304 Hungary 3305 Latvia 3306 Lithuania 3307 Poland 3308 Russian Federation 3311 Slovakia 3312 Ukraine 4101 Algeria 4102 Egypt 4103 Libya 4104 Morocco 4105 Sudan 4106 Tunisia 4107 Western Sahara 4111 South Sudan 4201 Bahrain 4203 Iran 4204 Iraq 4205 Israel 4206 Jordan 4207 Kuwait 4211 Oman 4212 Qatar 4213 Saudi Arabia 4214 Syria 4215 Turkey 4216 United Arab Emirates 4217 Yemen 5101 Burma (Myanmar) 5102 Cambodia 5103 Laos 5104 Thailand 5105 Viet Nam 5201 Brunei Darussalam 5202 Indonesia 5203 Malaysia 5204 Philippines 5205 Singapore 5206 East Timor 6101 China (excludes SARs and Taiwan) 6102 Hong Kong (SAR of China) 6104 Mongolia 6105 Taiwan 6201 Japan 6202 Korea, Democratic People's Republic of (North) 6203 Korea, Republic of (South) 7101 Bangladesh 7102 Bhutan 7103 India 7104 Maldives 7105 Nepal 7106 Pakistan 7107 Sri Lanka 7201 Afghanistan 7202 Armenia 7203 Azerbaijan 7204 Georgia 7205 Kazakhstan 7206 Kyrgyzstan 7207 Tajikistan 7208 Turkmenistan 7211 Uzbekistan 8101 Bermuda 8102 Canada 8103 St Pierre and Miquelon 8104 United States of America 8201 Argentina 8202 Bolivia 8203 Brazil 8204 Chile 8205 Colombia 8206 Ecuador 8207 Falkland Islands 8208 French Guiana 8211 Guyana 8212 Paraguay 8213 Peru 8214 Suriname 8215 Uruguay 8216 Venezuela 8299 South America, nec 8301 Belize 8302 Costa Rica 8303 El Salvador 8304 Guatemala 8305 Honduras 8306 Mexico 8307 Nicaragua 8308 Panama 8401 Anguilla 8402 Antigua and Barbuda 8403 Aruba 8404 Bahamas 8405 Barbados 8406 Cayman Islands 8407 Cuba 8408 Dominica 8411 Dominican Republic 8412 Grenada 8413 Guadeloupe 8414 Haiti 8415 Jamaica 8416 Martinique 8417 Montserrat 8421 Puerto Rico 8422 St Kitts and Nevis 8423 St Lucia 8424 St Vincent and the Grenadines 8425 Trinidad and Tobago 8426 Turks and Caicos Islands 8427 Virgin Islands, British 8428 Virgin Islands, United States 8431 St Barthelemy 8432 St Martin 9101 Benin 9102 Burkina Faso 9103 Cameroon 9104 Cape Verde 9105 Central African Republic 9106 Chad 9107 Congo 9108 Congo, Democratic Republic of 9111 Cote d'Ivoire 9112 Equatorial Guinea 9113 Gabon 9114 Gambia 9115 Ghana 9116 Guinea 9117 Guinea Bissau 9118 Liberia 9121 Mali 9122 Mauritania 9123 Niger 9124 Nigeria 9125 Sao Tome and Principe 9126 Senegal 9127 Sierra Leone 9128 Togo 9201 Angola 9202 Botswana 9203 Burundi 9204 Comoros 9205 Djibouti 9206 Eritrea 9207 Ethiopia 9208 Kenya 9211 Lesotho 9212 Madagascar 9213 Malawi 9214 Mauritius 9215 Mayotte 9216 Mozambique 9217 Namibia 9218 Reunion 9221 Rwanda 9222 St Helena 9223 Seychelles 9224 Somalia 9225 South Africa 9226 Swaziland 9227 Tanzania 9228 Uganda 9231 Zambia 9232 Zimbabwe Lebanon Moldova Please Enter Country of Birth Passport Number Please Enter Passport Number What is your First Language ? Select An Option Aboriginal English Acehnese Acholi Adnymathanha African Languages, nec Afrikaans Akan Alawa Albanian Alngith Alyawarr American Languages Amharic Amurdak Anindilyakwa Anmatyerr, nec Antekerrepenh Antikarinya Anuak Arabana Arabic Arandic, nec Armenian Arnhem Land and Daly River Region Languages, nec Aromunian (Macedo-Romanian) Arrernte, nec Assamese Assyrian Neo-Aramaic Auslan Azeri Baanbay Badimaya Balinese Balochi Bandjalang Banyjima Barababaraba Bardi Bari Basque Bassa Batjala Belorussian Bemba Bengali Bidjara Bikol Bilinarra Bisaya Bislama Bosnian Bulgarian Bunuba Burarra Burarran, nec Burmese Burmese and Related Languages, nec Cantonese Cape York Peninsula Languages, nec Catalan Cebuano Celtic, nec Central Anmatyerr Chaldean Neo-Aramaic Chin Haka Chinese, nec Croatian Czech Czechoslovakian, so described Daatiwuy Dadi Dadi Dalabon Dan (Gio-Dan) Danish Dari Dhalwangu Dhanggatti Dhangu, nec Dharawal Dhay'yi, nec Dhivehi Dhuwal, nec Dhuwala, nec Dhuwaya Dinka Diyari Djabugay Djabwurrung Djambarrpuyngu Djangu Djapu Djarrwark Djinang, nec Djinba Djinba, nec Dravidian, nec Dutch Dyirbal Eastern Anmatyerr Eastern Arrernte English Estonian Ewe Fijian Fijian Hindustani Filipino Finnish Finnish and Related Languages, nec French Frisian Fulfulde Ga Gaelic (Scotland) Galpu Gambera Gamilaraay Ganalbingu Garrwa Garuwali Georgian German Gilbertese Girramay Githabul Golumala Gooniyandi Greek Gudanji Gudjal Gujarati Gumatj Gumbaynggir Gun-nartpa Gundjeihmi Gupapuyngu Gurindji Gurindji Kriol Gurr-goni Guugu Yimidhirr Guyamirrilili Hakka Harari Hausa Hawaiian English Hazaraghi Hebrew Hindi Hmong Hmong-Mien, nec Hungarian Iban Iberian Romance, nec Icelandic Igbo IIokano Ilonggo (Hiligaynon) Indo-Aryan, nec Indonesian Invented Languages Iranic, nec Irish Italian Iwaidja Jaminjung Japanese Jaru Javanese Jawi Jawoyn Jingulu Kalaw Kawaw Ya/Kalaw Lagaw Ya Kanai Kannada Karajarri Karen Kariyarra Kartujarra Kashmiri Kaurna Kayardild Kaytetye Keerray-Woorroong Key Word Sign Australia Khmer Kija Kikuyu Kimberley Area Languages, nec Kinyarwanda (Rwanda) Kirundi (Rundi) Kiwai Koko-Bera Konkani Korean Kpelle Krahn Krio Kriol Kugu Muminh Kukatha Kukatja Kuku Yalanji Kunbarlang Kune Kuninjku Kunwinjku Kunwinjkuan, nec Kurdish Kuuk Thayorre Kuuku-Ya'u Kuwema Ladji Ladji Lamalama Lao Lardil Larrakiya Latin Latvian Letzeburgish Liberian (Liberian English) Light Warlpiri Lingala Lithuanian Liyagalawumirr Liyagawumirr Loma (Lorma) Luganda Lumun (Kuku Lumun) Luo Luritja Macedonian Madarrpa Madi Malak Malak Malay Malayalam Malngin Maltese Mandaean (Mandaic) Mandarin Mandinka Mangala Mangarrayi Manggalili Mann Manyjalpingu Manyjilyjarra Maori (Cook Island) Maori (New Zealand) Marathi Maringarr Marra Marramaninyshi Marrangu Marridan (Maridan) Marrithiyel Martu Wangka Matngala Maung Mauritian Creole Mayali Meriam Mir Middle Eastern Semitic Languages, nec Min Nan Miriwoong Mirning Mon Mon-Khmer, nec Mongolian Moro (Nuba Moro) Morrobalama Motu (HiriMotu) Mudburra Murrinh Patha Muruwari Na-kara Narungga Nauruan Ndebele Ndjebbana (Gunavidji) Nepali Ngaanyatjarra Ngalakgan Ngaliwurru Ngan'gikurunggurr Ngandi Ngardi Ngarinyin Ngarinyman Ngarluma Ngarrindjeri Ngatjumaya Nhangu Nhangu, nec Niue Norf'k-Pitcairn Northern Desert Fringe Area Languages, nec Norwegian Nuer Nungali Nunggubuyu Nyamal Nyangumarta Nyanja (Chichewa) Nyikina Nyungar Oceanian Pidgins and Creoles, nec Oriya Oromo Other Australian Indigenous Languages, nec Other Eastern Asian Languages, nec Other Eastern European Languages, nec Other Southeast Asian Languages Other Southern Asian Languages Other Southern European Languages, nec Other Southwest and Central Asian Languages, nec Other Yolngu Matha, nec Paakantyi Pacific Austronesian Languages, nec Palyku/Nyiyaparli Pampangan Papua New Guinea Languages, nec Pashto Persian (excluding Dari) Pintupi Pitjantjatjara Polish Portuguese Punjabi Rembarrnga Rirratjingu Ritharrngu Rohingya Romanian Romany Rotuman Russian Samoan Scandinavian, nec Serbian Serbo-Croatian/Yugoslavian, so described Seychelles Creole Shilluk Shona Sign Languages, nec Sindhi Sinhalese Slovak Slovene Solomon Islands Pijin Somali Southeast Asian Austronesian Languages, nec Spanish Swahili Swedish Tagalog Tai, nec Tamil Tatar Telugu Tetum Thai Thaynakwith Themne Tibetan Tigre Tigrinya Timorese Tiwi Tjungundji Tjupany Tok Pisin (Neomelanesian) Tokelauan Tongan Tswana Tulu Turkic, nec Turkish Turkmen Tuvaluan Ukrainian Urdu Uygur Uzbek Vietnamese Waanyi Wagilak Wagiman Wajarri Walmajarri Waluwarra Wambaya Wangkajunga Wangkangurru Wangkatha Wangurri Wanyjirra Wardaman Wargamay Warlmanpa Warlpiri Warnman Warramiri Warumungu Welsh Wergaia Western Arrarnta Western Desert Languages, nec Wik Mungkan Wik Ngathan Wiradjuri Worla Worrorra Wu Wubulkarra Wunambal Wurlaki Xhosa Yakuy, nec Yan-nhangu Yankunytjatjara Yanyuwa Yapese Yawuru Yiddish Yidiny Yindjibarndi Yinhawangka Yorta Yorta Yoruba Yugambeh Yulparija Yumplatok (Torres Strait Creole) Yupangathi Zomi Zulu Please Fill Up this Field How well do you speak English ? Very Well Well Not Well Not at all Please Select One Have you previously completed an English Proficiency test? Yes No Please Select One English Type Select An Option TOEFL iBT IELTS Cambridge (CAE) PTE OET Other Please Select One Please ensure you upload evidence of this test with your application Do you have Unique Student Identifier (USI)? Yes No Please Select One USI Number It must be 10 digits in length and consist of only capital letters and numbers, excluding I, 1, 0 and O I give permission to Laneway to search for my USI Please Select One Do you give permission to create a USI on your behalf? Yes No Please Select From the Field Is this application being lodged onshore (in Australia) or offshore? Onshore Offshore Please Enter - Currently in Australia or Not Have you, or any dependants, ever had any previous Visa applications rejected? Yes No Have you already lived in Australia on a Student Visa? Yes No Have you already studied a VET or HE course in Australia? Yes No What type of visa do you currently have ? Student Visa Tourist Visa Permanent Visa Other Please Select Visa Type What year did you arrive in Australia ? Year Please Select Arrived Year Visa Number Visa Expiry Date Please Enter Month Year Please Enter Year Next Contact Mobile Please Enter Mobile Number Email Please Enter Email Address Overseas Address Address 1 This value is required. Address 2 This value is required. City / Suburb This value is required. Post Code This value is required. Country None Selected 1101 Australia 1102 Norfolk Island 1201 New Zealand 1301 New Caledonia 1302 Papua New Guinea 1303 Solomon Islands 1304 Vanuatu 1401 Guam 1402 Kiribati 1403 Marshall Islands 1404 Micronesia, Federated States of 1405 Nauru 1406 Northern Ireland 1406 Northern Mariana Islands 1407 Palau 1501 Cook Islands 1502 Fiji 1503 French Polynesia 1504 Niue 1505 Samoa 1506 Samoa, American 1507 Tokelau 1508 Tonga 1511 Tuvalu 1512 Wallis and Futuna 1513 Pitcairn Islands 2102 England 2103 Isle of Man 2105 Scotland 2106 Wales 2107 Guernsey 2108 Jersey 2201 Ireland 2301 Austria 2302 Belgium 2303 France 2304 Germany 2305 Liechtenstein 2306 Luxembourg 2307 Monaco 2308 Netherlands 2311 Switzerland 2401 Denmark 2402 Faroe Islands 2403 Finland 2404 Greenland 2405 Iceland 2406 Norway 2407 Sweden 2408 Aland Islands 3101 Andorra 3102 Gibraltar 3103 Holy See 3104 Italy 3105 Malta 3106 Portugal 3107 San Marino 3108 Spain 3201 Albania 3202 Bosnia and Herzegovina 3203 Bulgaria 3204 Croatia 3205 Cyprus 3206 Former Yugoslav Republic of Macedonia (FYROM) 3207 Greece 3211 Romania 3212 Slovenia 3214 Montenegro 3215 Serbia 3301 Belarus 3302 Czech Republic 3303 Estonia 3304 Hungary 3305 Latvia 3306 Lithuania 3307 Poland 3308 Russian Federation 3311 Slovakia 3312 Ukraine 4101 Algeria 4102 Egypt 4103 Libya 4104 Morocco 4105 Sudan 4106 Tunisia 4107 Western Sahara 4111 South Sudan 4201 Bahrain 4203 Iran 4204 Iraq 4205 Israel 4206 Jordan 4207 Kuwait 4211 Oman 4212 Qatar 4213 Saudi Arabia 4214 Syria 4215 Turkey 4216 United Arab Emirates 4217 Yemen 5101 Burma (Myanmar) 5102 Cambodia 5103 Laos 5104 Thailand 5105 Viet Nam 5201 Brunei Darussalam 5202 Indonesia 5203 Malaysia 5204 Philippines 5205 Singapore 5206 East Timor 6101 China (excludes SARs and Taiwan) 6102 Hong Kong (SAR of China) 6104 Mongolia 6105 Taiwan 6201 Japan 6202 Korea, Democratic People's Republic of (North) 6203 Korea, Republic of (South) 7101 Bangladesh 7102 Bhutan 7103 India 7104 Maldives 7105 Nepal 7106 Pakistan 7107 Sri Lanka 7201 Afghanistan 7202 Armenia 7203 Azerbaijan 7204 Georgia 7205 Kazakhstan 7206 Kyrgyzstan 7207 Tajikistan 7208 Turkmenistan 7211 Uzbekistan 8101 Bermuda 8102 Canada 8103 St Pierre and Miquelon 8104 United States of America 8201 Argentina 8202 Bolivia 8203 Brazil 8204 Chile 8205 Colombia 8206 Ecuador 8207 Falkland Islands 8208 French Guiana 8211 Guyana 8212 Paraguay 8213 Peru 8214 Suriname 8215 Uruguay 8216 Venezuela 8299 South America, nec 8301 Belize 8302 Costa Rica 8303 El Salvador 8304 Guatemala 8305 Honduras 8306 Mexico 8307 Nicaragua 8308 Panama 8401 Anguilla 8402 Antigua and Barbuda 8403 Aruba 8404 Bahamas 8405 Barbados 8406 Cayman Islands 8407 Cuba 8408 Dominica 8411 Dominican Republic 8412 Grenada 8413 Guadeloupe 8414 Haiti 8415 Jamaica 8416 Martinique 8417 Montserrat 8421 Puerto Rico 8422 St Kitts and Nevis 8423 St Lucia 8424 St Vincent and the Grenadines 8425 Trinidad and Tobago 8426 Turks and Caicos Islands 8427 Virgin Islands, British 8428 Virgin Islands, United States 8431 St Barthelemy 8432 St Martin 9101 Benin 9102 Burkina Faso 9103 Cameroon 9104 Cape Verde 9105 Central African Republic 9106 Chad 9107 Congo 9108 Congo, Democratic Republic of 9111 Cote d'Ivoire 9112 Equatorial Guinea 9113 Gabon 9114 Gambia 9115 Ghana 9116 Guinea 9117 Guinea Bissau 9118 Liberia 9121 Mali 9122 Mauritania 9123 Niger 9124 Nigeria 9125 Sao Tome and Principe 9126 Senegal 9127 Sierra Leone 9128 Togo 9201 Angola 9202 Botswana 9203 Burundi 9204 Comoros 9205 Djibouti 9206 Eritrea 9207 Ethiopia 9208 Kenya 9211 Lesotho 9212 Madagascar 9213 Malawi 9214 Mauritius 9215 Mayotte 9216 Mozambique 9217 Namibia 9218 Reunion 9221 Rwanda 9222 St Helena 9223 Seychelles 9224 Somalia 9225 South Africa 9226 Swaziland 9227 Tanzania 9228 Uganda 9231 Zambia 9232 Zimbabwe Lebanon Moldova This value is required. Australian address Unit No Maximum character length is 20. Street No This value is required. Street Name This value is required. City This value is required. State -- Select -- NSW VIC QLD SA WA TAS NT ACT OTH (AUS) OVS (Overseas) This value is required. Postcode This value is required. Emergency Contact Number Please Enter Emergency Contact Number Contact Person Name Please Enter Contact Person Name Relationship Please Enter Relationship Back Next Education Are you still attending secondary/high school? No Yes Please Select One Option What year will you complete secondary school? Select year 2028 2027 2026 2025 2024 2023 2022 2021 2020 2019 2018 Please Select Year Name of Secondary School Please Enter Name of Secondary School When did you complete secondary school Select year 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 Please Select Year Highest School Level Completed -- Select level of education -- Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent Year 9 or equivalent Year 8 or below Never attended school Please Enter Highest School Level Completed Have you completed any prior education? Yes No Not Specified Please Select One Option Title and Recognition ID Title Bachelor degree or higher degree Recognition ID --Not specified-- A - Australian qualification E - Australian equivalent I - International Please Select Recognition ID Advanced diploma or associate degree --Not specified-- A - Australian qualification E - Australian equivalent I - International Please Select Recognition ID Diploma (or associate diploma) --Not specified-- A - Australian qualification E - Australian equivalent I - International Please Select Recognition ID Certificate IV (or advanced certificate/technician) --Not specified-- A - Australian qualification E - Australian equivalent I - International Please Select Recognition ID Certificate III (or trade certificate) --Not specified-- A - Australian qualification E - Australian equivalent I - International Please Select Recognition ID Certificate II --Not specified-- A - Australian qualification E - Australian equivalent I - International Please Select Recognition ID Certificate I --Not specified-- A - Australian qualification E - Australian equivalent I - International Please Select Recognition ID Other education --Not specified-- A - Australian qualification E - Australian equivalent I - International Please Select Recognition ID Please Select at Least One Educational Title Back Next Other Employment What is your current employment status ? Select Full-time employee Part-time employee Self-employed - not employing others Self-employed - employing others Employed - unpaid worker in a family business Unemployed - Seeking full-time work Unemployed - Seeking part-time work Unemployed - Not Seeking employment Please Enter Employment Type Existing Skills & Competencies Please list your existing skills and competencies Support Do you have any pre-existing learning difficulties, disabilities or other conditions, which many inhibit your learning or ability to undertake study in your chosen course ? Yes No Please Select a Radio Option Please indicate the areas (may include more than one) Hearing/Deaf Physical Intellectual Learning Mental Illness Acquired Brain Implement Vision Medical Condition Other Please indicate the areas Please Provide Details Please Fill Up Details Field Agent Details (Organization) I authorise the following agent to receive information related to my application Please Check The Checkbox Agency Name Please Enter Agency Name Counsellor Name Please Enter Counsellor Name Counsellor Email Please Enter Counsellor Email Back Next Documents Checklist Upload your documents for checking (we accept certified or verified true copies) Passport Choose Reset Enter Certified copy of your passport Academic documents Choose Reset Proof of English language ability Choose Reset Enter Proof of English language ability Other 1 Choose Reset Other 2 Choose Reset Off-Shore Student Off-Shore Student (Additional information is required) Off-Shore Student Have you or any of your dependants ever had a visa application rejected or an existing visa cancelled ? Yes No This radio field is required Please provide a summary of why this occurred This field is required How did you hear about Laneway Education? Agent Other This field is required Please let us know how you heard about us This field is required What are the reasons for choosing to undertake your selected course? This field is required Please explain how the course you have chosen will benefit your future plans. This field is required What are the reasons for choosing Laneway Education over other providers in Australia ? This field is required What are the reasons for choosing to study in Australia rather than in your home country ? This field is required How many years since you last studied? If there is a gap in your studies, please explain what you have been doing during this gap. This field is required Have you previously studied in Australia ? Yes No This field is required Please detail the courses you have previously studied and the outcome you achieved This field is required FINANCIAL DETAILS How do you intend to cover your tuition and living costs (including dependant/s)? Self-funded Sponsored Bank Loan Family Other This field is required Do you have access to sufficient funds* to support you and your dependants (if any) for the total period of your stay in Australia to ensure that you meet course progress? Yes No This field is required *This includes tuition fees, travel costs, living costs as outlined on the DIBP website: http://www.border.gov.au/Trav/Stud/More/Student-Visa-Living-Costs-and-Evidence-of-Funds Evidence of financial resources Choose Reset Back Next Course Details Campus Location Sydney Melbourne Please choose your course location Select Course Select CPC30220 Certificate III in Carpentry (114928D) CPC30620 Certificate III in Painting and Decorating (114930K) MSF30322 Certificate III in Cabinet Making and Timber Technology (114933G) BSB40120 Certificate IV in Business (106194D) BSB40820 Certificate IV in Marketing and Communication (106195C) 11210NAT Diploma of Entrepreneurship and Innovation (114969F) BSB50420 Diploma of Leadership and Management (104324D) BSB50620 Diploma of Marketing and Communication (106197A) BSB50820 Diploma of Project Management (104081G) CPC50220 Diploma of Building and Construction (Building) (114932H) ICT50220 Diploma of Information Technology - Front End and Back End Website Development Specialisations (106203H) ICT50220 Diploma of Information Technology - Cyber Security & Advanced Networking Specialisations (106203H) BSB60420 Advanced Diploma of Leadership and Management (106199K) BSB60520 Advanced Diploma of Marketing and Communication (106200M) RII60520 Advanced Diploma of Civil Construction Design (114934F) ICT60220 Advanced Diploma of Information Technology (113178A) BSB80120 Graduate Diploma of Management (Learning) (106201K) BSB80320 Graduate Diploma of Strategic Leadership (106202J) Please Choose your Course Intake Date Select Please Choose your Course Intake Date Study Reason Select To get a job To develop my existing business To start my own business To try for a different career To get a better job or promotion It was a requirement of my job I wanted extra skills for my job To get into another course of study Other reasons For personal interest or self-development To get skills for community/voluntary work Please choose your study reason Funding Source (National) Select 11 - Commonwealth and state general purpose recurrent 13 - Commonwealth specific purpose programs 15 - State specific purpose programs 20 - Domestic full fee-paying client 30 - International full fee-paying client (Until 2020) 31 - International onshore client (From 2020) 32 - International offshore client (From 2020) 80 - Revenue earned from another training organisation Please choose your national fund Do you wish to add another Course ? Yes No Do you wish to apply for RPL / CT? Yes No We will send you an RPL /CT application form and supporting information within 48 hours. Select Course Select CPC30220 Certificate III in Carpentry (114928D) CPC30620 Certificate III in Painting and Decorating (114930K) MSF30322 Certificate III in Cabinet Making and Timber Technology (114933G) BSB40120 Certificate IV in Business (106194D) BSB40820 Certificate IV in Marketing and Communication (106195C) 11210NAT Diploma of Entrepreneurship and Innovation (114969F) BSB50420 Diploma of Leadership and Management (104324D) BSB50620 Diploma of Marketing and Communication (106197A) BSB50820 Diploma of Project Management (104081G) CPC50220 Diploma of Building and Construction (Building) (114932H) ICT50220 Diploma of Information Technology - Front End and Back End Website Development Specialisations (106203H) ICT50220 Diploma of Information Technology - Cyber Security & Advanced Networking Specialisations (106203H) BSB60420 Advanced Diploma of Leadership and Management (106199K) BSB60520 Advanced Diploma of Marketing and Communication (106200M) RII60520 Advanced Diploma of Civil Construction Design (114934F) ICT60220 Advanced Diploma of Information Technology (113178A) BSB80120 Graduate Diploma of Management (Learning) (106201K) BSB80320 Graduate Diploma of Strategic Leadership (106202J) Please Choose your Course Intake Date Select Please Choose your Course Intake Date Do you wish to add another Course ? Yes No Select Course Select CPC30220 Certificate III in Carpentry (114928D) CPC30620 Certificate III in Painting and Decorating (114930K) MSF30322 Certificate III in Cabinet Making and Timber Technology (114933G) BSB40120 Certificate IV in Business (106194D) BSB40820 Certificate IV in Marketing and Communication (106195C) 11210NAT Diploma of Entrepreneurship and Innovation (114969F) BSB50420 Diploma of Leadership and Management (104324D) BSB50620 Diploma of Marketing and Communication (106197A) BSB50820 Diploma of Project Management (104081G) CPC50220 Diploma of Building and Construction (Building) (114932H) ICT50220 Diploma of Information Technology - Front End and Back End Website Development Specialisations (106203H) ICT50220 Diploma of Information Technology - Cyber Security & Advanced Networking Specialisations (106203H) BSB60420 Advanced Diploma of Leadership and Management (106199K) BSB60520 Advanced Diploma of Marketing and Communication (106200M) RII60520 Advanced Diploma of Civil Construction Design (114934F) ICT60220 Advanced Diploma of Information Technology (113178A) BSB80120 Graduate Diploma of Management (Learning) (106201K) BSB80320 Graduate Diploma of Strategic Leadership (106202J) Please Choose your Course Intake Date Select Please Choose your Course Intake Date Do you wish to add another Course ? Yes No Select Course Select CPC30220 Certificate III in Carpentry (114928D) CPC30620 Certificate III in Painting and Decorating (114930K) MSF30322 Certificate III in Cabinet Making and Timber Technology (114933G) BSB40120 Certificate IV in Business (106194D) BSB40820 Certificate IV in Marketing and Communication (106195C) 11210NAT Diploma of Entrepreneurship and Innovation (114969F) BSB50420 Diploma of Leadership and Management (104324D) BSB50620 Diploma of Marketing and Communication (106197A) BSB50820 Diploma of Project Management (104081G) CPC50220 Diploma of Building and Construction (Building) (114932H) ICT50220 Diploma of Information Technology - Front End and Back End Website Development Specialisations (106203H) ICT50220 Diploma of Information Technology - Cyber Security & Advanced Networking Specialisations (106203H) BSB60420 Advanced Diploma of Leadership and Management (106199K) BSB60520 Advanced Diploma of Marketing and Communication (106200M) RII60520 Advanced Diploma of Civil Construction Design (114934F) ICT60220 Advanced Diploma of Information Technology (113178A) BSB80120 Graduate Diploma of Management (Learning) (106201K) BSB80320 Graduate Diploma of Strategic Leadership (106202J) Please Choose your Course Intake Date Select Please Choose your Course Intake Date Comment The comment field is required. Back Next Declaration DECLARATION In signing the Laneway Education enrolment application form, I declare that: The information provided by me in this application form is true and correct. I have sufficient financial capacity to meet all of my course tuition fees including other related fees and agree to pay all fees as they become due. I have read and understand the course and fee information on the Laneway Education website http://www.laneway.edu.au and in the course information brochure. I understand that Australian law requires student visa holders to notify their Education Provider of any change of contact details including up to date contact number and address details within 7 days. I understand that it is compulsory to be covered by Overseas Student Health Cover while I am on a student Visa. I understand that I am not eligible to transfer to another registered provider without approval from Laneway Education and until I have completed 6 months of my principal course of study as per the Learner Transfer Policy and Procedure. I understand that continuation in the course/s is dependent upon satisfactory academic progress. Failure to meet these conditions will result in my case being reported by Laneway Education to the Department of Home Affairs (formerly Department of Immigration and Border Protection). I grant permission to Laneway Education to use my personal images and any course work produced during my studies. Such use includes the display, distribution, publication, transmission or otherwise use of photographs, images and/or videos taken for use in materials that include, but may not be limited to, printed materials such as Brochures, Newsletters, Videos and digital images used on Laneway's Website and Social Media Pages, such as Facebook and Instagram. I acknowledge that information about the ESOS Framework can be found at https://internationaleducation.gov.au/Regulatory-Information/Pages/Regulatoryinformation.aspx. It is important for international students to understand the ESOS Framework. The Education Services for Overseas Student Act (ESOS) and regulations set out the legal framework governing delivery of education to overseas students studying in Australia on a student visa. I understand that information collected about me may be shared between the registered provider and the Australian Government and designated authorities and, if relevant, the Tuition Protection Services (TPS). This information includes personal and contact details, course enrolment details and changes, and the circumstance of any suspected breach by the student of a student visa condition. In other instances, information collected on this form can be disclosed without your consent where authorised or required by law. I acknowledge that Laneway Education is committed to protecting an individual's right to privacy in accordance with the Privacy Act 1988. I acknowledge that Laneway Education reserves the right to alter any course, subject, admissions requirement or fee without notice. I have read and understand Laneway Education’s Management of Tuition Fees Policy and Procedure found at http://www.laneway.edu.au/policies I am aware that Laneway Education only accept students with a minimum age of 18 years at course commencement. If I instruct an agent or any authorised third party to complete this application form on my behalf, I do so on the basis that the agent or authorised third party is acting for me and it remains my responsibility to read the terms and conditions of the enrolment as outlined in any letter of offer I may receive. I authorise Laneway Education to verify the authenticity of my academic/professional qualifications and my work experience. I understand Laneway Education may inform other organisations or regulatory agencies if any of the information provided in my application is not true or accurate. Laneway Education reserves the rights to refuse or cancel any offer of enrolment if the information provided in this form is not true or accurate. Signature Date Signature Confirm Signature Reset Please press ‘Confirm Signature’ to verify your signature Image jQuery( document ).ready(function() { document.getElementById("theimage").src = ''; jQuery("#drawimage").click(function () { var canvas = document.getElementsByTagName("canvas"); document.getElementById("theimage").src = canvas[0].toDataURL(); Canvas2Image.saveAsPNG(canvas); }); document.getElementById("theimage1").src = ''; jQuery("#drawimage1").click(function () { var canvas = document.getElementsByTagName("canvas"); document.getElementById("theimage1").src = canvas[0].toDataURL(); Canvas2Image.saveAsPNG(canvas); }); }); Back Finish!