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 Please Enter Country of Citizenship Country of Birth None Selected Please Enter Country of Birth Passport Number Please Enter Passport Number What is your First Language ? Select An Option 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 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!
