AEMS

Your Personal Details:

Family name *:	Please fill in your surname
Given name *:	Please fill in your given names
Sex *:	Male Female
Citizenship *:
Date of Birth *:
Email *:	Please fill in your email address The email address above is not correct
Address *:
Telephone :
Fax :
*Visa :**	Do you already have an Australian Visa *? Yes No Type: Expiry:

Label

Your Education

Start Date	End Date	Major & Qualification *

*Institution :**

Start Date	End Date	Major & Qualification *

*Institution :**

Start Date	End Date	Major & Qualification *

*Institution :**

Other information about education

Your Language

First language *:

English level *:

English test :

Have you done a recognised English test in the last two years?
Yes No	Date taken:
Type:	Result:

Preferred Course Details

Enter details about your preferred coursed and duration (for example two years Master of mputer Science).

Course (1) :
Institution :		City :

Course(2) :
Institution :		City :

Do you want us to suggest some institutions and courses for you?
Yes No

Preferred starting date *:

Homestay required ?

Yes No

Airport pickup required ?

Yes No

*How do you support your study in Australia?

I'll pay the tuition fee and living costs
I'll pay the tuition fee and work part-time during study
Apply for scholarship and pay some of the costs by family/self
Apply for scholarship only

If you are able to pay all or part of the tuition fee and living costs,
please provide details of£º

*If you can't get scholarship, will you continue to apply for study?

Yes No

Family name:	Given name:	Relationship:	Age:

Details of Family Provide details of your family members who will be accompanying you to Australia.

Your Employment History

Start Date :	End Date :	Occupation :

Duties :

Start Date :	End Date :	Occupation:

Duties :

Start Date :	End Date :	Occupation :

Duties :

* What services do you need ?

You can choose one or more of the followings:

choose institution/course and arrange admission

visa application

Scholarship application

Other Information

Record any other information that you think might be relevant to your assessment here.

How do you know this company?

Thank You !


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