Enrollment form

Home / Australian regional permanent residency

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Course Code*

Course Name*

Tuition Fee*

NonTuition Fees

Current Residential Address*

City*

Location*

Mode Of Study*

Which intake month would you prefer?*

Are you applying for Recognised Prior Learning (RPL)?*

Yes

Agent Information

Has an Agent or Representative of AIBT assisted with this application?*

Yes

If Yes, please specify Name of Agent / Company

Personal Details

Gender*

Male

Female

Indeterminate/Intersex/Unspecified

Title *

Mrs

Miss

Family Name*

Given Names

Former Family Name

Date of Birth*

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

Yes

If yes, please provide USI details*

If no, please refer to section 14 of this enrolment application to apply for a USI.

Do you currently hold a visa?*

Yes

If yes, what type?*

Student

Working

Tourist

Other

Are you currently enrolled with another Australian education provider?*

Yes

Are you currently enrolled with another Australian education provider?*

Yes

Name of the education provider*

Name of course/s you are currently enrolled in*

Residential Address

Flat/Unit Number*

Street Number*

Street Name

Suburb/Locality or Town*

State*

Postcode*

Country*

Contact*

Postal Address (if different to Residential Adress)

PO Box (if applicable)

Street Number

Street Name

Suburb/Locality or Town

State

Post Code

Country

Student Contact

Phone*

Mobile

Emergency Contact

Name

Relashionship

Phone

Mobile

Language and Cultural Diversity

In which country were you born?*

Australia

Other

If other please specify*

In which city were you born?*

Non-Australian Passport No

Country of Passport*

Do you speak a language other than English at home? *

Yes

If Yes, please specify

How well do you speak English?*

Well

Very Well

Not Well

Not at All

English language proficiency*

IELTS

PTE

TOEFL

Other

Disability and Mental Health

Do you consider yourself to have a disability, impairment or long-term condition?*

Yes

No (If No, go to 10 Schooling Section)

If Yes, then please indicate the area of disability, impairment or long-term condition. You can select more than one area.*

Hearing/Deaf

Physical

Intellectual Learning

Mental illness

Acquired brain impairment

Vision

Medical condition

Other

Do you require special assistance?*

Yes

No (If No, go to 10 Schooling Section)

If yes, please explain the special assistance required

Schooling

What is your highest COMPLETED secondary school level? (tick ONE box only)*

Year 12

Year 11

Year 9

Year 8 or below

Never attended school

Which year did you complete that secondary school? level?*

Are you still attending secondary school?*

Yes

If yes. What secondary school are you attending?

Previous Qualifications Achieved

Have you SUCCESSFULLY completed any of the following qualifications?

Yes

If Yes, tick ANY applicable boxes*

Bachelor’s degree or higher degree

Advanced diploma or associate degree

Diploma (or Associate Diploma)

Certificate IV (or advanced certificate / technician)

Certificate III (or trade certificate)

Certificate II

Certificate I

Certificates other than the above

Employment

Of the following categories, which BEST describes your main reason for undertaking this course*

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 ofstudy

For personal interest orself-development

Unique Student Identifier

If you already have a Unique Student Identifier (USI), please provide this USI in section 3 in this enrolment application. If you would like us (AIBT) to apply for a USI on your behalf, you must authorise us to do so and declare that you have read the privacy information at: https://www.usi.gov.au/Training-Organisations/Pages/Privacy-Notice.aspx.

I authorise AIBT to apply pursuant to sub-section 9(2) of the Student Identifiers Act 2014, for a USI on my behalf.

I have read, and I consent to the collection, use and disclosure of my personal information pursuant to the information detailed at: https://www.usi.gov.au/Training-Organisations/Pages/Privacy-Notice.aspx.

Declaration

In signing or emailing this form, I acknowledge and declare that:

1. I am over the age of 18 years.

2. If I am under 18 years of age, my parent(s) or guardian(s) have signed permission for this enrolment and have arranged/will arrange for my accommodation, support and welfare arrangements, whilst studying in Australia until I turn 18 years of age.

3. I have read, understood and completed all questions and details on the enrolment form.

4. Prior to enrolment, I have had a Pre-Enrolment Consultation with either an approved Education Agent, AIBT Sales Manager or the AIBT Enrolments Team, where I have discussed the requirements of the course(s) that I am enrolling in and have received clear and accurate information and regarding the course(s) to enable me to make an informed decision that will reflect my existing skills and competencies and meet my needs.

5. I agree with the information provided in the enrolment form. I understand the requirements of the course(s) that I have enrolled in. This enrolment form is, to the best of my knowledge, true, correct and complete at the time of my enrolment (including information provided to assess my eligibility).

6. I agree that arrangements have been made to pay all fees and charges applicable to this enrolment.

7. I have read, understand and agree to follow the Information, Rules, Regulations, Policies and Procedures located in the Important Enrolment Information.

8. I agree that my participation in this course/s is subject to the right of AIBT to cancel or amalgamate courses or classes. I agree to abide by all rules and regulations of AIBT.

9. I confirm I have been informed about the training, assessment and support services to be provided and about my rights and obligations as a student at AIBT.

10. I authorise AIBT or its Education Agent, in the event of illness or accident during any AIBT organised activity, and where emergency contact or next of kin cannot be contacted within a reasonable time, to seek ambulance, medical or surgical treatment at my cost.

11. I agree that my academic results will be withheld until my debt is fully paid and any property belonging to AIBT has been returned.

12. I am responsible for keeping a copy of this document and any receipts for payment of tuition or nontuition fees.

Name (please print)*

Signature*

Date*

This field should be left blank

Full Name

Date of Birth

Gender

Current Residential Address

City

State

Post Code

Visa Details

Current Visa Subclass

Visa Expiry Date

Bridging Visa Holder

Yes No

Visa Conditions

Full-Time Work Rights?

Yes No

Any Past Visa Refusals or Cancellations in Australia

Yes No

If Yes, please provide details

Education Details

Highest Qualification Completed in Australia

Course Name

Institution Name

Start and Completion Dates

CRICOS Registered Course

Yes No

Location of Study

Employment Details

Current Occupation

Employer Name

Employer Location

Start Date with Current Employer

Type of Employment

Previous Relevant Work Experience (Australia)

Skills Assessment

Positive Skills Assessment Obtained

Yes No

Occupation Assessed

Assessing Authority

Date of Issue

Expiry Date (if applicable)

English Language Proficiency

English Test Taken

IELTS PTE TOEFL OET Cambridge

Test Date

Scores (Listening, Reading, Writing, Speaking):

Overall Score

Is the result valid (within last 3 years)?

Yes No

State Nomination Preferences

Are you currently living in Tasmania?

Yes No

If not, are you willing to relocate to Tasmania for nomination?

Yes No

Are you open to other regional areas for nomination (e.g., SA, NT, QLD Regional)?

Yes No

Do you have any family members living permanently in Tasmania or any regional area?

Yes No

If Yes, please specify

Employer Sponsorship Opportunities

Is your current employer willing to sponsor you?

Yes No

If Yes

Company Name

Number of Employees

Industry

Are you open to employer sponsorship from a new employer?

Yes No

Are you willing to commit to working in a regional area for sponsorship (e.g., 3-5 years)?

Yes No

Financial Situation (for Regional Nomination if required)

Can you show proof of financial capacity?

Yes No

Estimated Available Settlement Funds (AUD)

Other Information

Any health or character issues?

Any other relevant information for your migration plan?

I declare that the information provided is true and complete to the best of my knowledge. I understand providing false or misleading information may impact my migration outcome.

Signature

Date

+61 468 383 657

Enrollment Form

Home / Australian regional permanent residency

Agent Information

Personal Details

Residential Address

Postal Address (if different to Residential Adress)

Student Contact

Emergency Contact

Language and Cultural Diversity

Disability and Mental Health

Schooling

Previous Qualifications Achieved

Employment

Unique Student Identifier

Declaration

Visa Details

Education Details

Employment Details

Skills Assessment

English Language Proficiency

State Nomination Preferences

Employer Sponsorship Opportunities

If Yes

Financial Situation (for Regional Nomination if required)

Other Information

Quick Links

Visa Types

Contact Info

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