Graduate Certificate application and enrolment form

Required fields are marked with an asterisk (*).

Please select the Graduate Certificate course you wish to apply for *

Your details

Title *

Given name/s *

Surname *

Gender *

Male
Female
Trans/gender diverse

Date of birth *

Are you a previous Deakin student? *

If yes, enter your student ID *

Previous name, if applicable

Home / Postal address

Number and street *

Suburb *

State *

Postcode *

Mobile telephone *

Email *

Unique Student Identifier (USI) * If you do not have a USI, please visit USI.gov.au to generate one.

Are you an Australian citizen or permanent resident, or a New Zealand Citizen? * If No, do not complete this form. You will need to contact Deakin International on +61 3 9244 5095 or go to deakin.edu.au/international.

Education history

Enter the details of your highest qualification at post-secondary level. Please type not applicable, if you do not hold a post-secondary qualification.

Name of course *

Name of institution *

Completed *

Statistics about you

Please answer the questions in this section and submit your answers. If any of your information changes, you can re-submit your answers, at any time. Statistical information collected is reported to the Australian Government.

Descent

Are you of Aboriginal or Torres Straight Islander descent? *

No
Yes - of Aboriginal origin
Yes - of both Aboriginal and Torres Strait Islander origin
Yes - of Torres Strait Islander origin

Citizenship

What is your citizenship status this year? *

Australian citizen (including Australian citizens with dual citizenship)
Holder of Australian permanent humanitarian visa
Holder of Australian permanent visa (not a humanitarian visa)
International student who intends to study in Australia on campus, holder of Australian temporary entry visa, diplomat or dependent of a diplomat (except New Zealand)
New Zealand citizen, New Zealand diplomatic staff member or spouse/dependent (who is not also an Australian citizen)
International student who does not intend to study in Australia and does not meet any other citizenship category

Country of birth

In what country were you born? *

Australia
Overseas country

Overseas country of birth

When did you arrive in Australia? *

Residence

In what country is your permanent home residence? *

Australia
Overseas country

Postcode of permanent home residence *

Overseas country of permanent home residence

In what country is your residence during this trimester / semester? *

Australia
Overseas country

Postcode of residence during this trimester/semester *

Overseas country of residence during this trimester / semester

Language

What language do you speak at home? *

English
Other language

Select the language you speak at home

Secondary education

Please select the highest level of education you completed at school? *

Please specify the last year enrolled at school *

Education level

What is the highest level of educational achievement successfully completed prior to this course? *

Parent / Guardian education

What is your parent / guardian 1 highest educational attainment? *

What is your parent / guardian 2 highest educational attainment? *

Declaration

I hereby declare that the information provided is correct and complete *

I declare that to the best of my knowledge the information supplied in this application and the documentation supporting it are correct and complete.

Where records of prior study have been provided in support of my application, I authorise Deakin University to conduct a search and retrieval of my academic record from my previous institution/s to verify the information contained in my application.

I acknowledge that the provision of incorrect information or documentation relating to my application may result in withdrawal of any offer of a place and that such withdrawal may take place at any stage of the course, at the discretion of Deakin University.

I agree to abide by the Statutes, Rules and Regulations of the University.

I consent to my personal identifying data being provided to the Department of Education as is necessary for allocation of a CHESSN (Commonwealth Higher Education Student Support Number), and my SLE (Student Learning Entitlement).

For International students only – I declare that I am in possession of the appropriate visa for my intended study program.

I declare

Deakin University, is collecting your personal information to access your application for admission. Deakin will also use this information to communicate with you about your application and provide you with additional relevant material. Deakin will not disclose your information to any third party unless required by State and Commonwealth reporting requirements or where authorised by law.

Your application will be stored securely and will be securely destroyed when no longer required to support your study at Deakin.

Deakin University manages personal information it holds, including requests by individuals for access to their personal information, in accordance with the Privacy and Data Protection Act 2014 (Vic). You have a right to gain access to your personal information held by the University. Information about Deakin’s privacy practices is available at deakin.edu.au/privacy. You may obtain further information about privacy at Deakin by contacting the Privacy Officer at +61 3 5227 8524 or at privacy@deakin.edu.au.