FORM

SECTION 1: STUDENT PERSONAL DETAILS (AS STATED ON PASSPORT)

Given name

Family Name

Title

Gender

Male Female Other

Contry of birth

Date of birth

City of birth

Passport number

Nationality

First Language

DO YOU CURRENTLY HOLD AN AUSTRALIAN VISA?

Visa

Yes No

Visa Type

Where will you apply for your student visa?

Australia Overseas

SECTION 2: STUDENT CONTACT DETAILS

CONTACT DETAILS (IN AUSTRALIA):

Address

Suburb

State

Postcode

Phone No.

Mobile Number

Email

CONTACT DETAILS (OVERSEAS)

Street Number

Street Address

City

Zipcode

Country

Phone No.

Mobile Number

Email

EMERGENCY CONTACT DETAILS:

Contact Full Name

Relationship

Mobile Number

Email

SECTION 3: OTHER STUDENT SERVICES

DO YOU HAVE OVERSEAS STUDENT HEALTH COVER (OSHC)?

Yes No

Please note: it is a requirement of your student visa approval that you show evidence of current OSHC for the duration of student visa. It its student’s responsibility to get health coverage.

SECTION 4: PREVIOUS STUDIES

HAVE YOU PREVIOUSLY STUDIED IN AUSTRALIA?

Yes No

ARE YOU TRANSFERRING FROM ANOTHER EDUCATION PROVIDER?

Yes No

DID YOU COMPLETE YOUR COURSE?

Yes No

DO YOU HAVE A TRANSFER/RELEASE LETTER?

Yes No

SECTION 5: ENGLISH PROFICIENCY

IELTS - SCORE

PTE- SCORE

CAE-SCORE

OTHER

(PLEASE SPECIFY):

* Please note, only test results taken two years prior to commencement will be accepted.

** Please note that CIC reserves the right to ask applicant to sit for an Internal English Test in order to issue a Letter of Offer.

SECTION 6: GENUINE TEMPORARY ENTRANT(GTE)

ARE YOU AWARE OF THE GENUINE TEMPORARY ENTRANT (GTE) REQUIREMENTS PROVIDED BY THE DEPARTMENT OF IMMIGRATION AND BORDER PROTECTION (DIBP)?

Yes No

SECTION 7: PROGRAM SELECTION

Please select individual course or 2 years package

SECTION 8: DECLARATION OF FINANCIAL CAPACITY

I DECLARE THAT I AM AWARE OF AND UNDERSTAND MY FINANCIAL OBLIGATIONS RELATING TO STUDYING IN AUSTRALIA AND WITH COCOON INTERNATIONAL COLLEGE. I CONFIRM THAT I HAVE ACCESS TO THE FUNDS TO COVER ALL COSTS ASSOCIATED WITH MY STUDY AND LIVING EXPENSES WHILST IN AUSTRALIA REQUIRED AS OUTLINED BY DIBP (https://www.border.gov.au/Trav/Stud/More/Student-Visa-Living-Costs-and-Evidence-of-Funds).

SECTION 9: STUDENT DECLARATION

I have read, understood and accepted all the terms and conditions of enrolment including the Student Handbook containing policies and procedures and information that may be found on Cocoon International College website. I hereby agree to be bound and adhere to all applicable standards of conduct, laws, regulations, policies, and procedures of Cocoon International College, and acknowledge that failure to do so may result in the suspension or cancellation of my enrolment. I understand that I am not required to pay more than 50% of my tuition fees before my studies commence, but that I may do so if I choose and provide this in written format. By submitting this application, I declare that all information and documentation provided is accurate and true. I acknowledge that submission of false, incorrect, incomplete, or misleading information may result in the delay or cancellation of my enrolment. I authorise my agent to act on my behalf on all matters related to study and finance.

STUDENT FULL NAME (PLEASE PRINT)

STUDENT SIGNATURE

Date

FORM

SECTION 1: STUDENT PERSONAL DETAILS (AS STATED ON PASSPORT)

DO YOU CURRENTLY HOLD AN AUSTRALIAN VISA?

SECTION 2: STUDENT CONTACT DETAILS

CONTACT DETAILS (IN AUSTRALIA):

CONTACT DETAILS (OVERSEAS)

EMERGENCY CONTACT DETAILS:

SECTION 3: OTHER STUDENT SERVICES

SECTION 4: PREVIOUS STUDIES

SECTION 5: ENGLISH PROFICIENCY

SECTION 6: GENUINE TEMPORARY ENTRANT(GTE)

SECTION 7: PROGRAM SELECTION

SECTION 8: DECLARATION OF FINANCIAL CAPACITY

SECTION 9: STUDENT DECLARATION

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