UNDERGRADUATE APPLICATION
FOR ADMISSION 2013 – SYDNEY CAMPUS
This form may NOT be used for the Early Offer Program
Please tear out before completing. Applicants MUST refer to the application information whilst completing this form.
Please use BLOCK/CAPITAL letters, indicate with “N/A” where questions are not applicable and tick boxes where appropriate.
1.
InItIal applIcant InformatIon jkjvhgcgcvfxfgh hbhbjhvjhgc
1.1
Title
Surname/Family name
First name
Second/Middle name
Date of birth
Preferred first name
Gender
1.2
Male
Female
Home address
Number and street
Town/Suburb
State/Country
Telephone (home)
Telephone (work)
Mobile
1.3
Notification address
P/Code
Email
This is the address for all correspondence during the application process (print as above if the same as 1.2)
Number and street
Town/Suburb
State/Country
Telephone (home)
1.4
P/Code
Telephone (work)
Please state your country of birth
If you were not born in Australia, please indicate the day, month and year of your arrival in Australia
Please state the year permanent residency or Citizenship was granted
Applicants with permanent residency approval must have arrived in Australia before submitting their application.
1.5
Citizenship and residency status
(Note: Evidence of citizenship/residency status must be provided if requested)
Please tick the appropriate box
Australian Citizen
Australian Permanent Humanitarian Visa Holder
Australian Permanent Resident
New Zealand Citizen
Diplomatic or consular representative of New Zealand, or the spouse or dependent relative of such a representative
Other
If you ticked ‘Other’, you are considered to be an international student and are required to complete a separate application form – do not complete this form. Contact the Prospective Students Office for further details on +61 2 8204 4404 or at sydney@nd.edu.au
1.6
Aboriginal and Torres Strait Islander background
Please tick the appropriate box
Neither Aboriginal nor Torres Strait Islander origin
Of Torres Strait Islander origin
1.7
Of Aboriginal origin
Of Aboriginal and Torres Strait Islander origin
Additional background information
Religion
1.8
Languages spoken Please list all languages spoken at home in order of use
1.
1.9
2.
4.
Special circumstances
Medical/Disability support required?
1.10
3.
Previous Notre Dame study
Yes
No
If yes, please describe
Have you been a student previously at Notre Dame?
Yes
No
If yes, what was your student number?
Continued overleaf
2 of 4
2.
StudY prEfErEncES
2.1
Course preferences
Please refer to page 51 of this Admissions Guide for course information
1. Course name
Course code
2. Course name
Course code
3. Course name
Course code
Major (List one only. Please note this can be changed at your enrolment.)
Semester One, 2013
2.2
Commencement of study program
2.3
Mode of study
3.
tYpE of applIcant
3.1
Are you completing Year 12 in 2012?
Yes
No (go to part 3.2)
Are you an elite athlete?*
Yes
No
Are you completing the International Baccalaureate (IB) program?
Yes
No
Are you an interstate applicant?
Yes
No
Are you completing enough units to be eligible for an ATAR?
Yes
No
Full-Time
Semester Two, 2013
Part-Time
Name of School
Town/Suburb
State
Year of Completion
Board of Studies Student Number (eight digits)
Please note: by signing the declaration at the end of this form, applicants are authorising the University to access their results from the Board of Studies
Year 11 Semester Two results
HSC subject
3.2
Year 12 Semester One results
HSC subject
Grade/Mark/Rank
If you have completed Year 12 in the past 5 years and are using these results please include them here
ATAR/UAI/OP/IB results
