Enrolment Form 2017
PERSONAL DETAILS (as per passport)
Family Name: __________________________________________ Given Name: _____________________________
Date of Birth (dd/mm/yyyy): ____________________________________

Gender:MaleFemale

Country of Citizenship: ________________________________ Country of Birth: ____________________________Country of Passport: ___________________________________ Passport Number: __________________________
Australian Address: ________________________________________________________________________________
Suburb: __________________________________________________________Postcode: _______________________
Address Overseas: ________________________________________________________________________________
Mobile: (Overseas or Australia-Mandatory) _________________________________________________________
Email (Mandatory): __________________________________________________________________________________VISA
Do you already have a visa?
Yes /

No□

Which type of visa do you have:

If no, which type of visa will you apply for?
Student□

Working Holiday□ Visitor□ Student□ Working Holiday□

Dependant□ Visitor□ Dependant□

Other: _____________________________________□ Other _________________(Visa Expiry Date) ____________________(Visa Expiry Date)__________________
CONFIRMATIONOF ENROLMENT(COE)
Do you require a CoE?

□Yes. Which immigration office (DIBP) will you submit your visa application?__________________________________________________________________________________________________________□

No. Reason ________________________________________________(please attach documentary evidence)
ENGLISH PROFICIENCY (Please attach documentary evidence)

ENGLISH PROFICIENCY (Please attach documentary evidence)
Have you taken IELTS/TOEFL/ISLPR test in the last 12 months?
Yes (Please attach your results e.g. IELTS
results, academic transcripts or Certificates)□ No (It is mandatory to contact
QAT to arrange an Entry Test)

tOVERSEAS STUDENT HEALTH COVER (OSHC) (Please provide passport copy of spouse and children ifapplicable)
Do you want QAT to arrange your OSHC for you?
□Yes.

□ Single□ Couple

OSHC Start Date (dd/mm/yyyy):□Family_____________________________OURSE INFORMATION□ No. Applying by myself (I acknowledge that I am responsible for my own insurance)
COURSE INFORMATIONELICOS
057609G
062787B
062787B

Duration (weeks)
General English

Day / Eve

Start Date

□D□D □E

IELTS Preparation
IELTS Preparation (Part Time, Evening only) Mon/Tue: Writing & Reading
Wed/Thu: Speaking & Listening□ Mon/Tue□ Wed/Thu

Australia Moreton Education Group Pty Limited trading as Queensland Academy of Technology ABN 68 105823309
Level 4, 333 Adelaide Street, Brisbane 4000, Queensland Australia PO BOX 10862 Adelaide Street, Brisbane 4000
Telephone 07 3002 0888 Facsimile 07 3002 0808
National Provider Number: 31246 CRICOS Number 02746G

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Spoken and Written English Courses
Course Name
10362NAT

Certificate I in Spoken and Written English

30 weeks10363NAT

Certificate II in Spoken and Written English

25 weeks10364NAT

Certificate III in Spoken and Written English

25 weeksCertificate IV in Spoken and Written English - Further Studies

25 weeks

10365NAT

Start DateDuration (weeks)

Early Childhood Education and Care Courses

CHC30113

Certificate III of Early Childhood Education and Care

40 weeks

CHC50113

Diploma of Early Childhood Education and Care

92 weeks

CHC50113

Diploma of Early Childhood Education and Care (whenpackaged with Certificate III of ECEC)

68 weeks

Business and Management Courses
BSB40515

Certificate IV in Business Administration

25 weeks

BSB50215

Diploma of Business – Specialising in Project Management

40 weeks

BSB51915

Diploma of Leadership and Management - General (Evening)

52 weeks

BSB51915

Diploma of Leadership and Management – Majoring in Social Mediaand Digital Marketing (Daytime)

52 weeks

BSB61015

Advanced Diploma of Leadership and Management

40 weeks

Cookery and Hospitality Courses
SIT40516

Certificate IV in Commercial Cookery

76 weeks

SIT50416

Diploma of Hospitality Management (packaged)

24 weeks

EDUCATION BACKGROUND
Are you currently enrolled at another institution in Australia?
Yes. Which institute:

Program:
Do you require a release letter?

Duration:

Yes

NoNo.
Program:Previous Educational Institution:
Duration:
Highest Educational Attainment:
Do you require Credit Transfer/Recognition of Prior Learning (RPL)□YesNo
Supported documents must be attached for credit transfer/RPL to be considered

QAT PATHWAY PROGRAM (More information in brochure and our website)
Do you want to study at one of our pathway institutions after completion of your course at QAT?
NoYes
HOMESTAY (Minimum 4 weeks-Payable upon acceptance of Offer)
Do you want QAT to arrange homestay for you?

Yes

No

http://qat.qld.edu.au/international/forms-policies
VET COURSE INTAKE DATES-From 5/1/16, please refer to QAT website for full details
http://qat.qld.edu.au/international/forms-policies
OSHC DETAILSAll students on a student visa are required by the Department of Immigration and Border Protection tohave Overseas Student Health Cover (OSHC) for the duration of your visa. Please refer to QAT website fordetails
http://qat.qld.edu.au/international/forms-policies
ENTRY REQUIREMENTS-Please refer to QAT website for full details
http://qat.qld.edu.au/international/forms-policies

Australia Moreton Education Group Pty Limited trading as Queensland Academy of Technology ABN 68 105823309
Level 4, 333 Adelaide Street, Brisbane 4000, Queensland Australia PO BOX 10862 Adelaide Street, Brisbane 4000
Telephone 07 3002 0888 Facsimile 07 3002 0808
National Provider Number: 31246 CRICOS Number 02746G

Version 5-2017 || 2

PAYMENT INFORMATION
1. Telegraphic Transfer or Direct Deposit (please email the proof of payment to admin@qat.qld.edu.au )Bank Name: Bendigo Bank Ltd
Account Name: Australia Moreton Education Group Pty Ltd BSB: 633-000 A/C Number: 1254-07528
Swift Code: BENDAU3B
2. Bank Cheque: Australia Moreton Education Group Pty Ltd
3. Visa Card and MasterCard
4. Cash Payment (ONLY at QAT Reception)
1. Payment must quote the proposal number.
2. For overseas payments please include an extra AUD$25 to cover the International Bank transfer fee. The student isresponsible for paying the bank transfer fee being charged by the overseas bank.
3. For student visa holders :a. Student can pay full fees if they wish to, but they are not required to pay more than 50% up front.
b. In the event of early termination , all unpaid fees for the specific course need to be paid before the termination will beconsidered. Late payment and non-payment of fees are against Australian law and are reportable to the Department ofImmigration and Border Protection (DIBP) five days after the appeals process has been completed.

TERMS AND CONDITIONSFor Student Visa Holders:1.
If you are coming to Australia on a student visa, we will send you a Confirmation of Enrolment (CoE). You will need to take this CoE to your nearest
Australian Embassy or Consulate with your visa application form. Be sure to leave enough time for the Embassy or Consulate to issue your visa.
2.

You cannot change provider during the course without a written letter of release from QAT.

3.
For ELICOS program students, you are to maintain satisfactory attendance level (over 80%). For VET program students you are to maintain a satisfactory
course progress (minimum 50%). Any breach of these conditions may result in you being reported to the Department of Immigration and Border Protection(DIBP). QAT has an Appeals & Complaints process, which you can access if QAT intends to report you to DIBP for any reason.
4.
You should always inform QAT of any changes to your enrolment or start date at least a week prior in writing. Fill out a “Special Consideration Form”
which is available from QAT’s website and email to enrol@qat.qld.edu.au. Please note, if you fail to attend the school on your course start date without
contacting us in advance, QAT has 14 days to report the cancellation of your enrolment to DIBP. You are entitled to natural justice under ESOS Act
subsection 4A (1) (a) (i).
5.
You must attend orientation, since it is a legal requirement and falls within your CoE’s study plan. Failing to do so is reportable to DIBP. Your
Orientation date and time will be emailed to you prior to course commencement.
6.
If you are enrolled at another provider on a student visa, you need to provide QAT a release letter before we can issue your CoE.
7.
You must provide QAT with proof of your English language proficiency level before we can issue you with an unconditional CoE.
Courses, Fees and Timetables: From time to time, QAT may change its courses or course fees. Always be sure to check the very latest course enrolment
information. You can do this by emailing us or by checking our web site.

CONDITIONS OF ENROLMENT
1. The Student's Rights as a Consumer
This agreement, and the availability of complaints and appeals processes, does not remove the right of the student to take action
under Australia’s consumer protection laws. Even if the student has discussed refunds with QAT, the student will always have the right toget legal help to solve any problems. QAT regards the transparent and clear communication of this policy to the students in a language
which is understandable as being a high priority. As well as, on this form, refund procedures are outlined in the QAT grievance flow chart
displayed in the Student Orientation Handbook and on notices in every classroom.
2. Books and Equipment
The student will return any books or equipment lent to them by QAT
3. Excursions
The student understands that weekly excursions and activities are a valuable part of their language learning experience. While most ofthese activities will be free, sometimes there may be a small ($2-$20) charge for some outside activities. The student agrees to pay thesecosts if they occur and of the student decides to participate.
4. Medical Insurance
Overseas Student Health Cover (OSHC) is compulsory for students on student visas. If QAT is not arranging OSHC, student must provide
proof of currency.
5. Indemnity
When the student signs this form, the student understands that they release and indemnify QAT and all of its staff and agents from any
responsibility for any loss, damage or injury to themselves or any of their property. Neither the student nor any of my executors oradministrators will make any claims against QAT or its staff for any loss, damage, physical injury or death that occurs at the premises rented
by QAT or on any transfer or recreational, sporting or educational excursion conducted or arranged by QAT.
6. Communication of Personal Information
QAT will only use this information for the purposes of enrolling the student in their courses. Any information about the student which QAT has
will be made available for them if they ask for it. However, the student understands that this information may also be given
to Australian State or Federal departments or agencies, such as DIBP, and to the Fund Manager of the ESOS Assurance Fund, if
it is required by Australian law. At all times, QAT is bound to abide by the requirements of the Privacy Act (1988)
7. Change of Address and Contact Details
The student understands that they must advise QAT within 48 hours of any change in their address or contact details during their course.
PENALTY FOR CHANGE OF ENROLMENT
Revising Confirmation of Enrolment (COE) information such as the course, start date, course length, OSHC & DIBP Office will be subject to a
$50 administration fee per program. "No charge will be made if it is caused by the immigration (i.e. delayed processing of student visa),family
circumstance or medical issue. Supporting evidence must be provided where necessary. Administration fee will be paid upfront before
revised CoE is finalised."
Australia Moreton Education Group Pty Limited trading as Queensland Academy of Technology ABN 68 105823309
Level 4, 333 Adelaide Street, Brisbane 4000, Queensland Australia PO BOX 10862 Adelaide Street, Brisbane 4000
Telephone 07 3002 0888 Facsimile 07 3002 0808
National Provider Number: 31246 CRICOS Number 02746G

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Sponsored Students (SACM students AND DAYTIME COURSES ONLY)Are you applying for Financial Guarantee?
□ Yes (Please present your Financial Guarantee on commencement day)□ No (Please make payment on commencement day)
Payment Options (All courses except Diploma ECEC and Cookery)

Payment Options (Diploma ECEC and Cookery ONLY)□ Standard Payment Plan
□ Flexible Payment Plan ($50 service fee per enrolment)□ Pay in full
□ Flexible Payment Plan A ($50 service fee per enrolment)□ Flexible Payment Plan B ($100 service fee per enrolment)□ Pay In FullCookery)

Note: Once an offer is accepted, revising instalment plan will be subject to a $50 administration fee per enrolment.

REFUND POLICY (Please √ the box)
Please access our International Refund Policy from the QAT Policies menu at www.qat.qld.edu.au□ I have read and understood the Conditions of Enrolment and International Refund Policy on the QAT website /handout
CHECKLIST□□□□□□□

Completed ALL sections of this application
Read and understood the Terms and Conditions
Read and understood the Refund Policy
Provided evidence of English proficiency, if applicable
Attached certified copies of academic record, if applicable
Attached passport and visa
OSHC arrangement request (Provide passport of spouse and children if applicable)
STUDENT DECLARATIONREPRESENTATIVE'S STAMPInternational Communication Japan Pty Ltd
T/A ICN JAPAN
Suite702/233 Castlereagh St, Sydney, NSW,
2000, AustraliaTel)+61-9267-3318
Email)Info@johokan.jp

I have carefully read and understood the Terms and Conditions
on Page 3. I agree with all of the cancellation, refund and otherconditions listed. If I am a parent or guardian of a student who isenrolling, then I agree that all of the conditions are acceptable.
If using an education agent:□✔ I give my agent authorisation to act on my behalf on all
matters related to study and financeStudent's Signature________________________________________________________

Date (dd/mm/yyyy)_________________________________________________________

ENROLMENT PROCESS
1. Complete QAT Enrolment Form

2. Email Enrolment Form and Passport along with English proficiency if applicable to enrol@qat.qld.edu.au
3. Receive your offer, invoice and Written Agreement (acceptance of offer / instalment plan) within 48hours
4. Sign and return your completed Written Agreement / proof of payment / English proficiency evidence
to admin@qat.qld.edu.au within 45 days from the date of offer.
5. Receive your ECoE within 48 hours (CoE must be requested at least 2 weeks prior to commencement ofthe course)OR
5 days prior to the expiration of an existing visa (whicheveris earlier)
Australia Moreton Education Group Pty Limited trading as Queensland Academy of Technology ABN 68 105823309
Level 4, 333 Adelaide Street, Brisbane 4000, Queensland Australia PO BOX 10862 Adelaide Street, Brisbane 4000
Telephone 07 3002 0888 Facsimile 07 3002 0808
National Provider Number: 31246 CRICOS Number 02746G

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