Apply now (International)

Personal Details

Have you previously been enrolled at Chancellor Institute?

Yes

If Yes, what was your previous Student Number?

Previous Student Number

Name*

Prefix First Last

Email*

Phone (including country code)

Address (home country)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address (in Australia if known, otherwise leave blank)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Gender

Male

Female

Prefer not to disclose

Support services - Do you have a disability, impairment or long-term medical condition, which may affect your studies?

Yes

Please specify the condition and support services you require

This information is used in a confidential manner by our Faculty and Student Services teams to assist you in accessing support services

Do you identify as Aboriginal or Torres Strait Islander

Yes

Prefer not to say

Do you have a sibling studying at Chancellor Institute?

Yes

Identification

Passport Number

Passport Date of Issue

Passport Country of Issue

Country of Birth

Are you currently in Australia?

Yes

English Language Proficiency

Language Spoke At Home

How do you intend to meet the English language requirement?

English is my first language

English proficiency test (e.g. Cambridge, IELTS, TOEFL, DAAD)

Emergency Contact

Name

First Last

Relationship to you

Phone (including country code)

Previous Education and Employment

Highest Education Qualification

Name of Institution

Country of Institution

Completion Date

Do you wish to apply for recognition of prior learning (RPL)?

Yes

Course selection

Which subjects are you applying for?

List your preferred subjects (with unit code) in order of preference.

Which month do you wish to commence your studies?

Which year are you applying for?

Do you wish to enrol Full Time or Part Time?

Full Time

Part Time

Study Abroad (January 3 week intensvie)

Study Abroad (June 3 week intensvie)

Study Abroad (10 week term)

Do you wish to study:

On campus

Online only

How did you hear about Chancellor Institute?

Chancellor website

Careers' advisor

Family / friend

Current students

Social media

Expo / Fair

Other

Agent details (if applicable, otherwise leave blank)

Are you using an agent to assist you with your application?

Yes

If Yes, what is the name of the agent's company?

What is the name of the agent's representative who helped you?

Agent's Email

Agent's Phone

Declaration

By submitting this application form through my nominated representative or directly to Chancellor Institute, I, the applicant, confirm that*

All the information I have provided is accurate

I agree to the terms and conditions as outlined on Chancellor Institute's website and below:

All information supplied in this application form and any supporting documentation is true and correct. I will notify Chancellor Institute of any changes to the information supplied. Attached documents supporting this application become the property of Chancellor Institute and will not be returned to the applicant. Chancellor Institute reserves the right to vary or reverse any offer of admission or enrolment made on the basis of incorrect or incomplete information supplied. Chancellor Institute may communicate with third parties regarding the application and enrolment at Chancellor Institute. The information collected in this form and any attachments may be disclosed if authorised or required by law and/or in certain circumstances to the Australian Government and/or designated authorities in accordance with Chancellor Institute’s Privacy policy This Student Application Form will constitute part of the written agreement between the student and Chancellor Institute where an offer of enrolment is made. Applicants should print and retain a copy of the completed form for their personal records.