Undergraduate and Graduate Coursework

Application Form International

(Except for Honours and Graduate courses in Counselling, Psychology and
Veterinary - Please refer to the Murdoch University website for the forms)

Murdoch International Admissions

Murdoch University AGENT’S STAMP (In English including address, phone)
90 South St, Murdoch
Western Australia 6150
Telephone: +61 8 9360 6063
Facsimile: +61 8 9360 6491
[email protected]
www.murdoch.edu.au Staff name ...............................................................................................................................
CRICOS Provider Code: 00125J
Email address ...........................................................................................................................

1. Personal Details
Have you previously studied or applied to Murdoch University?   Yes   No

If ‘Yes’, please provide your Student ID number        

Title Family Name (As per passport or Identity card)

Given Names

Date of Birth

dd mm yyyy Sex   M  F Nationality

Country of Birth Passport/Identity Card Number (if available)

Are you currently living in Australia?   Yes   No

If no, which country you are currently living in

Student’s residential address in Australia (if known)

Student’s current home country address

Student’s Telephone number (Include country and area codes) Student’s Mobile / Cell Number (Include country and area codes)

Student’s Email Address

Emergency contact Relationship Telephone number (Include country and area codes)

2. Course Preference

I am applying for admission in   Semester One (February) Year 20   Semester Two (July) Year 20
Which course are you applying for?
Preference Course title Major Course Code*
(eg. MBA) (eg. Accounting) (eg. M1000)

1st preference

2nd preference

* Refer to Course Guide or go to the following link: http://handbook.murdoch.edu.au/courses/

Does your course selection correspond with your future career plans?
Yes No If you answered ‘No’, please provide the reason for studying this course below.

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If you are applying for a Graduate course, is the course you have chosen to study at Murdoch University related to your previous studies or work experience?
Yes No If you answered ‘No’, please provide the reason for studying this course below.

Have you included a second preference in your application?

Yes No If you answered ‘Yes’, please provide the reason why you have chosen this course as your second preference.

3. English Language Proficiency

Is English your first language?

Yes No If ‘No’, what is your first language?

Was English the language of Instruction during the final year of your secondary studies?

Yes No Year completed Country

Was English the language of Instruction during your post-secondary studies?

Yes No Year completed Country

Have you taken or will you be taking an English Test?

Yes No

Name of test Date of test dd mm yyyy

Location (City and Country) Result

Please note: Some courses have higher English language requirements. Murdoch University also accepts other English language tests. Please go to the
following link to find out the English requirements for each test: www.murdoch.edu.au/Future-students/International-students/Applying-to-Murdoch/
English-requirements

4. Academic Qualification (please include all studies undertaken including high school)
Documentary evidence of qualifications stated must be attached. Documents not in English must be accompanied by certified translations.
A. Current Studies - List details of current studies

Date Enrolled Date results will be

Name of qualification (including major) Name of Institution
(month/year) available (month/year)

Will you complete your current studies prior to the commencement of your proposed course at Murdoch University?

Yes No If ‘No’ please state why.

B. Previous Studies - List details of previous studies

Name of Institution Course Duration Date enrolled/completed
Name of Course/award (including major) Country
eg. MIT/Murdoch College month/year month/year to month/year

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Have you had any break in your studies and work history?

Yes No
If you answered ‘Yes’, please provide a statement outlining the reasons for breaks in your study/work history and specify the period of time below

Have you been excluded from any previous institution?

Yes No If you answered ‘Yes’, please state date, name of institution, country and for what reason?

5. Advanced Standing
Are you seeking advanced standing?

Yes No If ‘Yes’, you must attach detailed syllabus or curriculum for Advanced Standing to be assessed.
This must include course content, assessment mode, contact hours, prescribed texts, etc

6. Personal Statement
Students applying to Graduate courses or Undergraduate courses in Veterinary Science, Nursing, Sports Science and Chiropractic are
required to provide a personal statement, Curriculum Vitae (CV) and references to support their application. The personal statement
should be no more than 500 words and should include information that will assist the selection committee to assess your application. For
example, you might explain how your previous studies, research or work experience relate to the course for which you are applying.

7. Work Experience
Please list details of any work experience. You must attach a CV with relevant work experience. Also include national service details if applicable

Period of Employment
Employer Position Held
From To

8. Equity and Disability

If you have a disability which means that you may require additional help at Murdoch University, it is very important that you provide
the following information. This information will be kept confidential and will not affect your admission to the University.

Type of Disability:   Vision   Hearing   Mobility   Impairment   Learning   Psychiatric   Other

Please attach a brief statement about your special needs.

9. Visa Details
Are you a Permanent Resident of Australia? Yes No
If ‘Yes’, you will be required to apply as a domestic student. Please see the following link: http://www.murdoch.edu.au/Future-students/Domestic-
students/Applying-to-Murdoch/

Current Australian visa number as shown on your visa label (if applicable)

Visa type:   Student   Visitor   Spouse Subclass Expiry date: dd mm yyyy

Other visa type:

If you hold a current passport/Australian visa, you must include a copy with this application.
Have you previously visited or studied in Australia before?
Yes No
Have you breached any visa conditions?
Yes No If ‘Yes’, provide details below

Have you been refused a visa for entry into Australia?

Yes No
If ‘Yes’, please provide a copy of the visa rejection letter.

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Have you ever had a visa application rejected (country other than Australia)?
Yes No
If ‘Yes’ provided a copy of the rejection letter or reason below.

Are you married?

Yes No If ‘Yes’ date of marriage: dd mm yyyy

Is your spouse currently in Australia?

Yes No

If ‘Yes’ what visa type does your spouse have? Expiry date: dd mm yyyy
Will you be accompanied by your spouse and/children during your studies in Australia?

Yes No If ‘Yes’, provide details of all your dependants:

Full name Date of Birth: dd mm yyyy

Full name Date of Birth: dd mm yyyy

Full name Date of Birth: dd mm yyyy

Full name Date of Birth: dd mm yyyy

If you have more dependants, attach a separate sheet with the remaining dependants details.
Do any members of your family hold a Temporary Resident Visa?

Yes No If ‘Yes’, please specify

I understand that my visa may be rejected or cancelled by the Immigration Department if it is determined that documents supporting my application
are fraudulent or I have made a false declaration.
Yes No
I understand that my visa application will be denied if I do not pass Immigration Department’s health and character checks.
Yes No
I understand that my visa application will be rejected if the Immigration Department is not satisfied that I am a genuine student.
Please go to the following link for more information: www.immi.gov.au/students/_pdf/2011-genuine-temporary-entrant.pdf
Yes No
I understand that my visa may be cancelled by the Immigration Department if I do not abide by the conditions of my visa.
These conditions include:
• I must remain enrolled in a registered program; Yes No
• I must maintain a full-time study load; Yes No
• I must maintain satisfactory program progression for the duration of my program; and Yes No
• I must not downgrade my program to a lower level such as a VET Certificate. Yes No
Please go to the following link for more information: www.immi.gov.au/students/visa-conditions-students.htm
I fully understand that if I request a transfer to another provider within the first six months of my study, Murdoch University may refuse my request.
Yes No
I understand that Murdoch University is required to advise the Immigration Department if I transfer to another education provider and I will need to
seek advice from Immigration Department about another student visa.
Yes No

10. Financial Information

Who will be paying your tuition fees and living expenses to study at Murdoch University? (If more than one source, please check all relevant boxes)
  Private sponsor eg. Employer, family member   Self-Funded
  By Bank Loan   Approved government, institution sponsor
Please go to the following link for tuition fees information:
www.murdoch.edu.au/Future-students/International-students/Courses-and-fees/?pid=my13_fs_is_banner_courses
I have an understanding of how much it will cost for the duration of the course/degree.
Yes No
Please go to the following link for costs of living information provided by the Australian Government: www.studyinaustralia.gov.au/en/Study-Costs/Living
I have an understanding of how much it will cost to live in Australia.
Yes No
I understand my obligation to have sufficient funds to pay for Overseas Student Health Cover, tuition fees, student amenities fees,
associated student costs, living and travel expenses for myself and any dependant/s for the entire duration of my stay in Australia.
Yes No

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I understand that if I am unable to pay my tuition fees in line with the payment due date, Murdoch University will cancel my enrolment
which may affect my student visa.
Yes No
I understand that while, as part of my student visa, I am allowed to work a maximum of 40 hours per fortnight (with unlimited work-rights during
semester breaks), these funds are to be used to supplement my living costs but must not be my only source of income to pay my tuition fees.
Yes No

11. Declaration and Agreement

TRUTH AND ACCURACY CANCELLATION AND REFUNDS
1. I declare that I am a genuine temporary entrant and 13. I agree that if I give notice of withdrawal more than ten weeks
genuine student. before commencement of the semester/trimester, all tuition fees
2. I declare that all the information I have given in this application paid in advance are refundable less 10% of the semester/trimester
is true, correct and complete, and is not false or misleading. I tuition fees due or $500 whichever is lesser.
understand giving false or misleading information is a serious 14. I agree that if I give notice of withdrawal less than ten weeks
offence under Australian law. (www.immi.gov.au/students/_ before commencement of the semester/trimester, but prior to the
pdf/2011-genuine-temporary-entrant.pdf) start of the semester/trimester, all tuition fees paid in advance are
3. I agree that Murdoch University (“the University”) can vary refundable less 30% of the coming semester/trimester tuition fee.
or reverse any decision made on the basis of any incorrect, 15. I agree that if I withdraw from the University after commencement
incomplete, false or misleading information that I have provided. of the semester/trimester but before the census date, I shall
This may result in my enrolment being terminated. be eligible for a refund of fees paid for the current and future
4. I agree to tell the University immediately if there is any change to semesters/trimesters less 70% of the fee for the current semester/
the information I have given in this application. trimester.
16. I agree that if I withdraw from the University after the census date
PRIVACY AND DISCLOSURE I shall be eligible for a refund of fees paid for the current and
5. I understand that the University may obtain official records from future semesters/trimesters less 100% of the fee for the current
my current or previous educational institution or employer. semester/trimester.
6. If any organisation is named in documents provided by me as 17. I confirm that I have read and understand the University’s Fees
part of my application (e.g. as evidence of my qualifications or Policy (including refunds) at: www.murdoch.edu.au/Future-
work experience) then I authorise that organisation to release any students/International-students/Courses-and-fees/Paying-fees/
personal information that it holds about me to the University so Refund-policy-for-International-students/
that the University can verify the information I have provided.
7. I authorise the University to release any personal information that FINANCIAL OBLIGATIONS
it may hold about me to any other educational institution that 18. I agree to provide any financial information requested by the
is seeking to verify my student conduct or academic record for University at any time for the purpose of the University assessing
the purpose of determining my eligibility for admission to, or my financial ability to undertake a course of study.
enrolment at, that institution. 19. I understand that the University will not act as a financial
8. I understand that any information about me that is provided guarantor for me, and I am solely responsible for all expenses
to, or maintained by, the University may be given to Australian incurred by me and my dependents, including as the result of
government departments and agencies as required by law. legal action, while I remain in Australia on a visa issued for the
This information includes, but is not limited to, changes to my purposes of studying at the University, whether or not I have
enrolment and any breach of a student visa condition relating to completed the course or remain enrolled at the University.
attendance or satisfactory academic performance. The University
may also provide relevant information about me to organisations WHILE I AM ENROLLED AT THE UNIVERSITY
at which I undertake a work placement or practicum as part of 20. While I am enrolled at the University:
my course. a. I agree to be bound by all the rules, regulations, statutes,
bylaws and any relevant policies of the University;
9. If the payment for my course is made by someone else (“sponsor”), b. I must enrol in a study pattern that allows me to complete my
I agree to the release of all information to my sponsor regarding course within the course duration set in my Confirmation of
my application and subsequent enrolment including my subject Enrolment (COE);
results, progress reports, and enrolment details (including c. If I am not the holder of a student visa, I understand that it is
contact details). my responsibility to ensure that the visa I hold permits me to
10. If I am under 18 years of age, I consent to the release of undertake the course in which I enrol at the University.
information regarding my academic performance and attendance d. I agree to update any changes to my personal details (Address,
to my parent(s) and/or guardian(s). Phone Number) direct to the Murdoch University Student
System within seven days of the change taking place.
PREVIOUS DISCIPLINARY ACTION
11. I declare that I have not been excluded or subject to disciplinary APPLICABLE LAW
action at any tertiary institution. 21. This declaration and agreement, and the availability of complaints
and appeals processes, does not remove my right as a student to
TRANSFER FROM ANOTHER EDUCATION INSTITUTION IN AUSTRALIA
take action under Australia’s consumer protection laws.
12. I agree to advise the University of any studies that I am
undertaking or will undertake with another provider at the same 22. This declaration and agreement is governed by Western Australian
time that I plan to study at the University. I understand that, in law. I agree to submit to the non-exclusive jurisdiction of the
these circumstances, the University cannot to offer me enrolment. courts of Western Australia.
I understand that I must present any documents requested by the
University to confirm my status.

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12. Application Check List
You must attach certified copies of award certificates and full academic transcripts, including keys to the grading
system used. All documents must be in English; if not, please include certified English translations.
Have you:   Completed the relevant application form for your study? Application forms can be downloaded at:
http://www.murdoch.edu.au/Future-students/International-students/Applying-to-Murdoch/Application-forms/
  Answered all the questions on this form?
  Attached certified copies of all necessary documents?
  Attached certified English translations of documents not in English?
  Attached certified copies of your English language proficiency (if applicable)?
  Attached a copy of your CV (if applicable)?
  Attached a certified copy of your passport (Biodata page) or ID?
  Attach a copy of your personal statement (if applicable)?

13. Applicant Declaration (to be completed by the applicant)

If you do not meet Academic and/or English entry requirements, do you give Murdoch University permission to forward your application to one of
Murdoch University’s preferred packaged partners?
Yes No

I,

Understand that there will be additional costs involved if I am undertaking pre university studies with Murdoch University’s preferred pathway
partners as provided on the offer letter.

Understand the current living costs in Perth, Western Australia, is as indicated on the Study in Australia website at
www.studyinaustralia.gov.au/en/Study-Costs/Living, and I declare that I have access to funding for the living expenses of myself and my
dependents in Australia for the duration of the course or courses which have been offered.

Understand that I will be required to update any changes to my personal details direct to the Murdoch University Student System
within seven days of my arrival in Perth. These details will only be passed onto the Immigration Department when requested by the
Immigration Department.

Declare that I have personally completed this application form.

Declare that I will abide by the University rules and policies and Murdoch University Act 1973-1985 and the By-laws, rules and policies of the
University (where applicable).

Declare that I have read, understood and agree to abide by the above terms and conditions. I consent to the use of my personal information
as set out above.

Declare that the information provided by me in the application is true and correct.

WARNING: It is an offence to submit fraudulent documentation in support of a course application.

Where fraudulent documents are detected the application will be rejected, any offer of enrolment will be
withdrawn, and the matter may be reported to relevant state and federal law enforcement agencies.

Applicant’s signature

Date
Applications that are unsigned, or are not ticked to indicate that the applicant has read the above terms and conditions and undertakes to abide by the
relevant rules and policies, will not be processed. Applications must be completed by the applicant personally. A third party must not complete or sign
on the applicant’s behalf.

14. Agent Declaration

I declare that:
• I have assessed the applicant as a Genuine Temporary Entrant and a Genuine Student as defined by the Immigration Department.
• The applicant is genuine in making this application and has every intention of completing all programs listed in the application.
• I have made every effort to verify the authenticity and validity of the documents which form part of this application.

Murdoch University Agent name Murdoch University Agent staff name

Agent’s signature

Date

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