Admissions Form International Student Form International Student Form Courses Details (Tick Applicable Course) * RII60520 Advanced Diploma of Civil Construction Design (CRICOS Course Code: 107777F) BSB50820 Diploma of Project Management(CRICOS Course Code:112234F) BSB80120 Graduate Diploma of Management (Learning)(CRICOS Course Code: 112233G)BSB80120 Graduate Diploma of Management (Learning)(CRICOS Course Code: 112233G) MF30322 Certificate III In Cabinet Making And Timber Technology(CRICOS Course Code:112947F)MF30322 Certificate III In Cabinet Making And Timber Technology(CRICOS Course Code:112947F) Do you want to apply for Recognition of Prior Learning (RPL) Yes No Do you want to apply for Credit Transfer (CT) Yes No PARTICPANT DETAILS (As shown on Identification supplied) Title: Mr Mrs MissMiss DrDr Name Name First First Middle Middle Last Last Date Of Birth Gender: Male FeMale UnspecifiedUnspecified Onshore Address: Onshore Address: Onshore Address: Onshore Address: City City State/Province State/Province Zip/Postal Code Zip/Postal Code Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Overseas Address: Overseas Address: Overseas Address: Overseas Address: City City State/Province State/Province Zip/Postal Code Zip/Postal Code Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Email * Contact No: Relationship: Emergency contact no: Emergency contact name: Overseas Contact Number: RESIDENCY OR VISA DETAILS Do you hold a current Australian Visa: Yes, Specify: No If no, what type of visa will you be applying for: Where will you lodge this visa In Australia Outside Australia INDIVIDUAL NEEDS Do you require assistance with Reading, Writing or Math? Yes, Specify: No Do you consider yourself to have a disability, impairment or a long-term health condition: In Australia Outside Australia If yes, please indicate the areas of disability, impairment, or long-term health conditions: Hearing/Deaf Physical IntellectualIntellectual VisionVision Acquired Brain ImpairmentAcquired Brain Impairment Mental illnessMental illness LearningLearning Medical ConditionMedical Condition OtherOther Do you require any special learning support: Yes No ENGLISH LANGUAGE PROFICIENCY Do you speak a language OTHER THAN English at home: Yes, Specify: No Specify Proficiency in English: Very Well Well Not Very WellNot Very Well Have you undertaken an English Language Proficiency Test in last 2 years? Yes No Please Select the relevant Proficiency Test you have undertaken and write score: IELTS (Academic)Pearson Test of English (Academic)Certificate in Advanced English (CAE)Occupational English Test (OET)TOEFL Paper Based (PB)TOEFL Internet Based (IBT)Oxford Placement Test (OPT)Cambridge English Advanced (CAE) Please Select the relevant Proficiency Test you have undertaken and write score: Overall Band / Score: Date to Sit Exam: I will sit an English language proficiency test in the future: IELTS (Academic)Pearson Test of English (Academic)Cambridge English Advanced (CAE)Occupational English Test (OET)TOEFL Paper Based (PB)TOEFL Internet Based (IBT)Oxford Placement Test (OPT)Cambridge English Advanced (CAE) I will sit an English language proficiency test in the future: EDUCATION Highest completed school level: Year 12 or Equivalent Year 11 or Equivalent Year 10 or EquivalentYear 10 or Equivalent Year 9 or EquivalentYear 9 or Equivalent Year 8 or EquivalentYear 8 or Equivalent Never AttendedNever Attended Year completed school: Are you currently enrolled in any studies: Yes No If yes, please specify: Have you every successfully completed any following qualifications in Australia? Certificate I Certificate II Certificate III Certificate IV Diploma Adv Diploma Bachelor’s Degree or Higher Degree Level Overseas qualification Recent Qualification Name: Qualification Start date: Completion date: Institute Name and Address: If Yes, Agent Name: We require certified copies of your academic qualifications attached to this application. If your qualifications are in a language other than English, you are to supply certified translated copies. All Documents will be verified by Pinnacle Institute for accuracy and authenticity. Current Education Provider Are you transferring within the first 6 months of your principal course? Yes No If yes, an original copy of a letter of release is required from your provider. Are you submitting a letter of release from your current education provider? Yes No STUDY REASONS which BEST describes your main reason for undertaking this course? (Tick ONE box only.) To get a job To develop my existing business To start my own business To get into another course of study To try for a different career To get a better job or a promotion It was a requirement of my job I wanted extra skills for my job For personal interest or self-development Other reasons How did you hear about the College: Word of Mouth Search Engine Print AD Employer Forum Other Would you like Pinnacle Institute to contact you to further discuss your enrolment? Yes, Via Phone Yes, Via Email No CULTURAL BACKGROUND Do you identify as: Aboriginal Torres Strait Islander (TSI) Both Aboriginal and TSI Neither Country of Birth: City of Birth: OVERSEAS STUDENT HEALTH COVER (OSHC) Under the Australian Government Department of Home Affair‘s student visa conditions, you must maintain an adequate OSHC for the duration of your studies in Australia. As this course is a secondary offering, please supply your OSHC details below: Name of OSHC provider: OSHC membership number: OSHC Expiry Date: From 1 January 2015, Pinnacle Institute is prevented from issuing you with a nationally recognised VET qualification or statement of attainment when you complete your course if you do not have a Unique Student Identifier (USI). In addition, we are required to include your USI in the data we submit to NCVER. If you do not have a USI, please visit www.usi.gov.au and create your USI. Would you like the College to arrange a health cover for you and dependents (if applicable)? Yes No I have a USI & give permission for Pinnacle Institute to search this number on my behalf I do not have a USI but give permission for the RTO to make an application for one on my behalf eitherthrough the RTO or Student Portal, using one of the identification items supplied. If yes, which health cover is applicable to you? Individual Couple FamilyUNIQUEFamilyUNIQUE UNIQUE STUDENT IDENTIFIER (USI) USI Number: STUDENT DECLARATION AND CONSENT Student Name: Date: I declare that the information I have provided on this form is complete and accurate. I understand that my enrolment is subject to my compliance with all Pinnacle Institute policies and procedures, which I have read and understood. I have read and understood information related to Pinnacle Institute courses, fees, location, policies and procedures and other relevant information available in the Student Handbook available from the Pinnacle Institute website. I will pay all the applicable fees as they become due and accept that non-payment of fees may result in a cancellation of my enrolment and trigger a debt-recovery process through a third party. I agree that I will be liable for any costs associated with debt-recovery and any associated legal costs if I fail to pay my Pinnacle Institute fees as they become due. I understand that information collected on this form may be used by Pinnacle Institute in accordance with the Pinnacle Institute Privacy Policy. I agree to abide by the policies, rules and regulations of Pinnacle Institute as relevant to my enrolment as a student of Pinnacle Institute. I authorise for my agent to act on my behalf with all correspondence from Pinnacle Institute Yes No Step 1: Complete the enrolment details on Pages 1 to 5Step 2: Attach the following documents:• Certified copy of passport title page, or original sighted by Pinnacle Institute• Copy of Visa Grant Notification Letter• Copy of your last completed academic qualification from your home country and/or Australia, if relevant• Evidence of English proficiency• IELTS 5.5 or equivalent English proficiency; Copy of any international English test results (e.g. IELTS / TOEFL / PTE); OR• proof that the student has successfully completed an English Language course with an Australian educational institution exiting at an Upper Intermediate level; OR• statement from educational institution or similar evidence that confirms that English was the language ofinstruction, if at least five years’ studies completed in Australia, UK, USA, Canada, New Zealand, South Africa orRepublic of Ireland; OR• Confirmation that the student has successfully completed in Australian the English language either the Senior Secondary Certificate of Education or studies at the Certificate IV or higher level, in the two years before applying to Pinnacle Institute; OR• Cambridge C1 Advanced test results (Scale Score Level B2)• Pre-Course Questionnaire (if applicable)• Primary Confirmation of Enrolment (if applicable)• Timetable for Primary Course of Study (if applicable) • Evidence of Course Progression (if applicable)• Statutory declaration – Confirming you will progress in your primary course of study(if applicable)Step 3: Submit your enrolment form, with the above documents to Pinnacle Institute:• in person at our office• by email to: admin@pin.edu.au• by mail to: PO BOX 3365, Sunnybank South Qld 4109Step 4: If your application is successful, you will receive a Letter of Offer detailing paymentrequirements. You must sign the Letter of Offer and return to us with proof of paymentand Overseas Students Heath cover evidence (if not arranged by Pinnacle Institute), within2 weeks of the date of the Letter of Offer.Step 5: After we receive your payment and signed Letter of Offer, we will issue an electronic‘Confirmation of Enrolment’ (eCOE). If other conditions have been noted on your letter of offer, you will be required to meet the conditions before an eCOE can be issued.Step 6: You will receive a Welcome Email outlining the details of your Orientation. We look forward to welcoming you at Orientation. Captcha Submit Form Start Over If you are human, leave this field blank.
