IDP Office

Student Assessment Sheet

Institution Name

Student Name Date of Birth

Course Intake

Source of Funds Privately Funded Government Scholarship

Requirements Yes No Pending / NA

1. Student details (name, date of birth and address) match those on their current ID

2. Course selection matches academic / professional background and requirements

3. Student can establish reasons for choosing Australia as a study destination

4. Student has a good idea of how the course will assist their career goals

5. If packaged, student has been briefed of their pathway options and progression
6. Student’s original academic, English language and work experience documents
have been sighted and exact copies supplied
7. Student can provide satisfactory reasons for any unexplained break in their
employment or education history
8. Student is aware that DIBP will cancel their visa application (including visa
applications of their spouse /dependants) if any information / documents provided
are found to be fraudulent
9. Evidence of income / availability of funds provided by Student / family / sponsor
for support of the Student and/or dependants while undertaking the study
programme is satisfactory and original documents have been sighted
10. Student (including accompanying spouse and/or dependants, if any)
has visa / immigration links to Australia. If Yes, list links in comment box
11. Student (including accompanying spouse and/or dependants, if any) has had visa
rejection(s) from any country. If Yes, list countries in comment box
12. Student is intending to bring spouse and/or dependants (if any) to Australian while
studying. If Yes, list in comment box
13. Student is fully aware of total cost of tuition, living expenses, OSHC and other
costs to undertake study in Australia for self and/or dependants (including spouse)
and has been referred to DIBP’s website
14. Student is aware that no institution will fund their studies if at any time they are unable
to pay required tuition fees and related expenses for duration of their stay in Australia
15. Student is aware that they are required to abide by all conditions of their student visa
while studying in Australia including but not limited to: maintaining address information
and OSHC, work conditions, academic performance and satisfactory attendance
16. Students under the age of 18, have the necessary approvals and arrangements in place

Comments

Counsellor’s Full Name Signature Date

IDP provides the information in and with this form in good faith to identify whether the Student meets
DIBP’s Simplified Student Visa Framework (SSVF) requirements and the Institution’s entry requirements.
The final decision to accept any prospective student remains with the Institution.

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IDP EDUCATION PTY - Application cover sheet – 1st July 2016
IDP Office

Student Declaration Form

Please respond by ticking the appropriate box.

1. I understand that IDP relies on information provided by me in good faith to match the characteristics
and published entry requirements of education institutions they represent.
I also understand that the final decision to accept my application will be made by the relevant
education institution.
2. I confirm that the information I have given in this application is genuine. I understand giving false or
misleading information may lead to termination of my admission offer and visa if at any time my information
is found to be not genuine.
3. I understand IDP collects my personal information to enable my request for obtaining information on study
opportunities, for applying to study at education institutions via IDP and for my student visa application
to be processed.
4. I am aware that I must immediately advise IDP if I find that any information provided in this application
is incorrect or if there is any change in my circumstances that is relevant to my application or to my visa
or my dependants’ visas including my ability to support myself and my dependants financially.
5. I declare that neither I nor my dependants including spouse(if any) have been refused a visa or are currently
awaiting a decision on:
A migration visa for any country (including Australia) List, if any:
Any other visa (including study visa) for any country (including Australia) List, if any:
6. I declare that neither I nor my dependants including spouse accompanying me (if any) have breached
the conditions of any visa held at any time to enter Australia or any other country.
7. I authorise IDP to contact any person, institution or organisation named in my application or supporting
documents and authorise IDP and those persons, institutions and organisations to disclose any relevant
information they may hold about me and my dependants (if any) for verification of my application
and supporting documents.
8. I confirm that:
I have access to sufficient funds to support myself and my spouse / dependants (if any) for the total period
of my visa. I acknowledge that I may be required to provide additional documentation to confirm my ability to
meet all necessary expenses as referred to on
https://www.border.gov.au/Trav/Stud/changes-financial-requirements
OR
I will be sponsored by my government / department and they will bear all my tuition and living expenses for
the duration of my stay. The Financial Guarantee letter from the relevant body is subject to issue of a Letter of
Offer from the relevant education institution.
9. I understand that I am obliged on acceptance of a Confirmation of Enrolment (CoE) to comply with all terms,
conditions and policies of the institution granting the CoE including in respect of:
- any cancellation or amendment of any course or program;
- refund of any course or program fees; and
- transfer from the institution granting my COE. AND
I also understand that while in Australia, I am required to abide by all applicable laws and regulations including
without limitation working restrictions, academic performance, satisfactory attendance and all other conditions
of my student visa.
10. I understand I will have reasonable access to my personal information held by IDP and will be able
to request correction of any personal information that is incorrect or no longer accurate
(see also https://www.idp.com/global/footerlinks/privacypolicy)

I have read and understand each of the above statements and give my consent to the use of my personal information
as set out above.

Full Name Signature Date

To be signed by Applicant or Parent/Guardian if Applicant under 18 years of age.

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IDP EDUCATION PTY – STUDENT DECLARATION FORM – SSVF: 1st July 2016
 International Admissions
Application Form

Please read this form carefully before completion. Complete ALL sections in BLOCK CAPITALS in
BLACK INK, and attach certificates/other required documentation.

APPLICATION FOR:

Name of Institution:

………………………………………………………………………………………………………………………………………………………

1. APPLICANT DETAILS.

Surname / Family name ........................................................................... Male Female

Previous Surname/Family name ......................................... ………. Title: Mr/Mrs/Miss/Ms/Other ...

First / Given name(s) ...............................................................................................................

Date of Birth (dd-mm-yy) _ _ /_ _ /_ _ Nationality ………………………… Country of birth. ...........

Permanent home address: Correspondence address
Address: ......................................................... IDP Education Ltd, Bandung branch office
City/Town: ..................................................... Jl Sulanjana No. 3 Dago
Country .......................................................... Bandung 40116 Indonesia
Postcode ........................................................ Ph: (+62 22) 426 1054
Tel (inc STD code) ............................................ Email: info.bandung@idp.com

Mobile number .......................................................................................................................

Email address ........................................................................................................................
This will be the main method of communication with applicants, please ensure details are legible and accurate.

Have you been resident in the Australia / UK / USA / Canada / NZ for the last Yes No
3 years?

2. COURSE OF STUDY APPLIED FOR:

Name of course (including award title e.g. BSc):

.............................................................................................................................................
Mode of study: Full time Part time Distance Learning
Location: campus (if known)
Proposed start date __ __ Month _ _ _ _ Year
If you are applying for advanced entry (APL) please indicate proposed year: Yr1 Yr2 Yr3
Yr4 Yr5 Yr6

Page 1 IDP Education Ltd - 28/10/2016– Application Form

3. FEES INFORMATION You must give details of who will be paying your fees. A sponsor is defined as a company or
other organization and does not refer to a private individual, such as a member of your family.

Who is expected to pay your fees? Yourself Parents Sponsor

Name and address to which invoice is to be sent (if different from above)
.............................................................................................................................................
…………………………………………………………………………………………………………………………………………………………………..
...................................................................... Post Code .......................................................

4. EDUCATION Please give details of all Schools/Colleges/Universities attended and currently attending since the age of 16
years together with dates, paying particular attention to include all institutions at which you have studied within the UK.
Secondary/Further/Higher Education
Name of Secondary Address / City Dates Attended
School/College/University From (mm/yy)
To (mm/yy)

5. EDUCATIONAL QUALIFICATIONS: please list all completed and partially completed academic qualifications
in date order, specifying the subjects studied and the grades achieved. Please ensure that copies of your certificates are provided with your
application; including official translations if qualifications are not in English. If applying for APL please provide copies of official transcripts, a
list of pending modules with associated credit weightings (if applicable) and syllabus.
A. Educational Qualifications
Subject Level (eg UAN, IGCSE, IB, BA, Grade Date (mm/yy)
MSc)

B. English Language Qualifications

Title of qualification Awarding body (and verification Grade (including scores for Date (mm/yy)
ID for TOEFL and IELTS) individual skills if applicable)

Have you previously studied in the Australia / UK / USA / Canada / NZ ? Yes No

Are you intending to undertake English Language studies with the University Pathway provider
before
commencing your degree program? Yes No

C. Qualifications currently being studies (award pending)

Subject Level (eg IGCSE, IB, BA, MSc) Date (mm/yy)

Page 2 IDP Education Ltd - 28/10/2016– Application Form

 D. Other Certificate Awards
Subject : (Accounting) Awarding Body : (CPA) - Jakarta Date (mm/yy)

6. EMPLOYMENT Please give details of current and previous employers, together with dates. If the course you are applying for
requires professional/work experience as part of the entry criteria, please provide details of your employment on a separate sheet of paper
(such as a curriculum vitae which should include an outline of the responsibilities associated with each position).
Organisation Position held and summary of Dates
responsibilities From (mm/yy) To (mm/yy)

7. REFERENCE All applicants must provide two references. The referees should be a course tutor if you have been in education
within the last two years and/or your current or most recent employer. Candidates applying on the basis of work experience must provide at
least one reference from their most recent employer. The referee should not be a friend or family member. References must be provided on
letter headed paper, signed and dated.

Name of referee 1 ........................................... Name of referee 2 ............................................

Organisation ................................................... Organisation ....................................................
Relationship to you ........................................... Relationship to you............................................
Mobile No. : ………………………………………………………….. Mobile No. : …………………………………………………………..
E mail Add : ………………………………………………………….. E mail Add. : …………………………………………………………
Reference enclosed Reference to follow Reference enclosed Reference to follow

Please tell us where you found out about this course

Agent Institution Representative Institution Website Friends / Family
Others ……………………………………………………………………………………………………………………………………………….

Page 3 IDP Education Ltd - 28/10/2016– Application Form

8. SUPPORT REQUIREMENTS: Please complete this section if you have any disability, medical condition or specific
learning difficulty learning. If you require further advice please contact IDP Education Pty. Ltd.

Do you have a disability, medical condition or specific learning difficulty? Yes No

If yes please name the condition and give brief details; our Student Support Service will contact you
.........................................................................................................................................
.........................................................................................................................................

I agree to the University / IDP processing personal data contained in this form or other data which
the University / IDP may obtain from me or other people. I agree to the processing of such data for
any purposes connected with my studies or my health and safety whilst on the premises or for any
legitimate reason including communication with me following the completion of my studies.
In addition, I agree to the University / IDP processing personal data described as “Sensitive Data”,
such processing to be undertaken for any purposes as indicated in the declaration above.
If my employer/sponsor is supporting my studies by paying my fees/allowing me study time I agree
to my employer/sponsor being informed of the progress of my application and of my studies if I am
accepted onto the course.

Agent Referral and Nominated Access

To be completed if applying with the assistance of a recruitment agent or if you are likely to
be away at any time and wish to nominate someone who can make decisions on your behalf and
discuss your studies with us. Please enter the full name(s) of your nominee and their relationship to
you.
I confirm that I give the following person(s) authorization to discuss my application and/or studies
with the relevant University, and receive correspondence from the University on my behalf.
Relationship/company : IDP Education Ltd, Jl Sulanjana No. 3 Dago, Bandung 40116 Indonesia
Ph: (+62 22) 426 1054, mobile: (+62) 819 1066 1001,
Email: info.bandung@idp.com

Declaration
I certify that, to the best of my belief, the information I have provided is complete and true.

Signature of Applicant ............................................. Date …………………

Signature of Guardian ............................................... Date …………………

if applicant is under 18 years

Please return this completed form with photocopies of the following documentation by email
attachment to e mail address above or by post to IDP Education Pty Ltd. Address above.

□ Curriculum Vitae
□ Photo copy of passport
□ Photocopy of Qualification certificates (in Indonesian and English)
□ Personal Statement
□ Photocopy of References (2: 1 from academics and 1 from supervisor at work or 1 from academics)
□ Photocopy of English test result
□ Portfolio (if specified as a requirement in the programme entry criteria)
□ Photocopy of Research proposal
□ Evidence of correspondence with potential supervisor

Page 4 IDP Education Ltd - 28/10/2016– Application Form