International Guide 2021

CONTINUED OVERLEAF 1. APPLICANT TYPE English Pathway Program Academic Pathway Program Undergraduate Postgraduate: Coursework Research 2. YOUR DETAILS 2.1 Have you been a student previously at Notre Dame? No Yes If yes, please indicate your previous student number 2.2 Title First name Family / Surname Second / Middle name Date of birth (day/month/year) Gender Given name as shown in your passport (if different to above) – – Male Female Have you been known by another name? Yes No If so, what was your previous name? 2.3 CONTACT INFORMATION Permanent address in home country Address Town/suburb State/country Postcode Telephone (include country code) Mobile/cell Email Notification address – this address is for all correspondence during the application process. Print ‘as above’ if the same as home address . Address Town/suburb State/country Postcode Telephone (include country code) Mobile/cell 2.4 PASSPORT DETAILS (If you are a Safe Haven/Humanitarian visa holder, please provide a copy of your ImmiCard). Passport number Expiry date Country of citizenship Country of birth 2.5 LANGUAGES – Please list all languages spoken at home in order of use. 2.6 MEDICAL OR SPECIAL NEEDS – disclosing this information will not affect your admission to the University. Do you have a disability or impairment? Yes No If yes, please indicate the disability or impairment below: Acquired brain injury Intellectual disability Neurological condition Specific learning disability Mental health condition Deaf / deaf Low vision / blind Medical condition Physical disability Other disability 3. APPLICATION TO STUDY – if you are applying for a research program , please ensure to complete PART C of this form. 3.1 Program preferences – Campus Fremantle Sydney 1. Program name Program code 2. Program name Program code 3. Program name Program code Intended commencement of study program (see notredame.edu.au/current-students/your-enrolment/calendars-and-timetables) : Year Semester 1 Semester 2 Do you intend to apply for advanced standing (credits or exemptions) based on your previous studies? Yes No International Application for Admission Please refer to the back of this document for instructions on how to complete this form. Please use BLOCK/CAPITAL letters, indicate with “N/A” where questions are not applicable and tick boxes where appropriate. PAGE 1 OF 6 PART A Do you require medical or disability support during your studies? Yes No