Online Application Please enable JavaScript in your browser to complete this form.12345 Document Before you complete this Enrolment Form please read all available information and Course Pre- Information on our website. If you have any enquiries, please contact Medicus College or email us from the Contact Us link on our website http://mtad.edu.au/. Once signed and the issue of a receipt for initial fees this document is a binding contract. INTERNATIONAL STUDENT ENROLMENT FORM Personal Details Unique Student Identifier (USI) – Refer to Page 4 for assistanceNameFirstLastHome AddressAddress Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeTelephone NumberEmail AddressDate of BirthMaleFemaleLanguage and Cultural Diversity Country of BirthAustralian CitizenshipYesNoAre you of Australian Aboriginal or Torres Strait Islander origin?YesNo(For persons of both Aboriginal and Torres Strait Islander origin, mark both ‘Yes’ boxes.)AboriginalYesNoTorres Strait IslanderYesNoHow well do you speak English?Very wellWellNot wellNot at allMain language spoken at home if not EnglishDisabilityDo you consider yourself to have a disability, impairment or long-term condition? YesNoIf YES, then please indicate the areas of disability, impairment or long-term condition Hearing/DeafLearningVisionPhysical Mental IllnessMedical ConditionIntellectual Acquired Brain ImpairmentOther(You may indicate more than one area.) EducationWhat is your highest COMPLETED school level? (ONE box only.)Year 12 or equivalentYear 11 or equivalent Year 10 or equivalentYear 9 or equivalentYear 8 or belowNever attended schoolIn which YEAR did you complete that school level? Are you still attending secondary school?YesNoPrevious Qualifications Have you SUCCESSFULLY completed any of the following qualifications?Bachelors Degree or Higher Degree Advanced Diploma or Associate DegreeDiploma (or Associate Diploma)Certificate IV (or Advanced Certificate/Technician)Certificate III (or Trade Certificate) Certificate IICertificate ICertificates other than the aboveIf YES, then tick ANY applicable boxesEmploymentOf the following categories, which BEST describes your current employment status? (ONE box only.)Full-time employeePart-time employeeSelf-employed - not employing othersEmployerEmployed - unpaid worker in a family businessUnemployed - seeking full-time workUnemployed - seeking part-time workNot employed - not seeking employmentNextProgram HistoryTo get a jobTo get a better job or promotionTo get into another course of studyTo develop my existing business It was a requirement of my jobFor personal interest or selfdevelopmentTo start my own businessI wanted extra skills for my jobOther reasonsTo try for a different careerDo you wish to apply for Recognition of Prior Learning?YesNoProposed StudyProposed commencement date:Fee CalculationEnrolment Fee OtherTotal Fee AmountNo obligation is created on Medicus College until an official receipt is issued Document Other Potential Fees LEADR External Complaint Resolution Fee No Charge Re sit assessment due to Academic Misconduct $400.00 Administration/Enrolment Fee (Non-refundable) $300.00 Replacement Certificate $100.00 Re-enrolment Fee $500.00 Use of Photocopier $0.10 1st Reassessment No Fee Welfare Service - Medicus College Referral Service No Charge 2nd Reassessment No Fee Welfare Service - Medicus College Representative No Charge 3rd and subsequent Reassessment $400.00 Welfare Service - External Professional Fees $50 + Note: There is a possibility for potential fees to change during a student’s course and applicable refund policies Table 1 Refund Circumstances Refund Amount Withdrawal at least Four (4) weeks prior to the agreed start date Full refund Withdrawal at least two (2) weeks prior to agreed start date refund equal to 80% of the tuition fees less enrolment fee of $300 Withdrawal less than one (1) week prior to agreed start date refund equal to 50% of the tuition fees less enrolment fee of $300 Withdrawal after the agreed start date No refund Course withdrawn by Medicus College Full refund Medicus College is unable to provide the program for which the original offer was made Full refund PreviousNext Document Refund Policy If an applicant accepts a place offered by Medicus College and pays the fees, it means a binding contract is created between the student and Medicus College. Under current legislation, there are a number of circumstances where a student may be in default. Notification of cancellation/withdrawal from unit/s of competency, withdrawal or deferral from a program of study must be made in writing to Medicus College. In the case of cancellation/withdrawal, the cancellation fee will be calculated as shown at Table 1. Medicus College offers the following information in relation to refunds of program money in the case of student and provider default: Amounts that may or may not be repaid to the student; Processes for claiming a refund; A plain English explanation of what happens in the event of a program not being delivered; and A statement that “This agreement, and the availability of complaints and appeals processes, does not remove the right of the student to take action under Australia’s consumer protection laws”. A total or partial refund is applicable when: Medicus College default This policy applies to an intending student in relation to a program if: The program does not start on the agreed starting day; or The program ceases to be provided at any time after it starts but before it is completed; or The program is not provided in full to the student because a sanction has been imposed on the registered provider; And the student has not withdrawn before the default day Student Default This policy also applies to all students or intending students in relation to a program if: The program starts on the agreed starting day, but the student does not start the program on that day (and has not previously withdrawn); or The student withdraws from the program (either before or after the agreed starting day); or The registered provider of the program refuses to provide, or continue providing, or provide progress documentation for a program to the student because of one or more of the following events: The student failed to pay an amount he or she was liable to pay the provider, directly or indirectly, in order to undertake the program; Misbehaviour by the student. Medicus College will make a refund within four (4) weeks of a Provider Default or receiving a written claim by the student in accordance with the Terms and Conditions as outlined on this Enrolment/Application Form All refund considerations will be strictly limited to the total of monies which Medicus College has received. The refund calculation will not include: Application/enrolment fees are non-refundable; If a student notifies Medicus College of their intention to withdraw from individual units or a program before their original start date, then they will be eligible to receive a refund minus a $500 administration charge/application fee; No refunds will be given for notification of withdrawal which occurs after the start of the program. The exception to this is noted in paragraph four (4) Once training has commenced in the program e.g. Diploma of Customer Engagement, no refund is available to participants who leave before finalising the program unless the student can provide a medical certificate or show extreme personal hardship. In that case, fees may be refunded on a pro-rata basis, minus the administrative fee/deposit. However, should participants wish to resume their studies at a later date, the original fee payment can be used as credit towards that program within twelve months of initial payment. Refund requests should be made in writing. Proportion of program money received for the proportion of the program provided to the student before the default date; If a student notifies Medicus College of their intention to withdraw before the original start date and are eligible for a refund as per paragraph three (3) above, then the refund will be paid within four (4) weeks of Medicus College receiving your request for refund. No academic penalty will be incurred if a student notifies Medicus College of their intention to withdraw from individual units or a program before the end of week four (4) of the semester All fees and charges are payable upon invoice and will cover a period of the impending study period. Students may be precluded from sitting exams, receiving results or attending classes if tuition fees are not paid by the date specified on the invoice Any refund will be paid to the person or entity that originally paid the program fees and, where possible, in the same currency in which the fees were paid. A Transfer of Provider, if requested and approved according to the appropriate policy as listed on the organisation website, will require a percentage payment to the end of current term when the transfer is requested or a minimum payment of one (1) month tuition fee plus the administration fee of $500.00. Fees may be subject to change without notice. In all circumstances Medicus College will provide a statement and an explanation of how the refund was calculated and make fully available access to Medicus College Grievance Policy. This agreement and the availability of Medicus College Complaints and Appeals process, does not remove the right of the student to take action under Australia’s consumer protection laws. PreviousNextFees Collection Medicus College collects student fees in advance and therefore it will comply with the following options for initial and continuing fee collection and registration: Students, or the person responsible for paying the tuition fees, can now choose to pay more than 50 per cent of their tuition fees before they start their course; Medicus College cannot require students to pay more than 50 per cent of their tuition fees before they start the course. A further 50% fee is due at the commencement of the second semester; Any payment plan for any outstanding fees will be negotiated and will be detailed on a separate document and will only apply to the second payment. Disclaimer Students are requested to declare at your time of enrolment anything that might prevent you from satisfactorily progressing through the training and assessment program e.g. anything related to physical ability, cultural background or educational background. Medicus College will not accept liability for any issue not declared at enrolment that has a potential to prevent satisfactory progress Medicus College Commitment Medicus College undertakes to provide a course/program corresponding to the requirements of the relevant National Training Package and the respective qualification as identified by this application as well as being compliant to the National Vocational Regulator Standards as accredited by the Australian Skills Quality Authority.Applicant SignatureClear SignatureDateThis agreement, and the availability of complaints and appeals processes, does not remove the right of the student to take action under Australia’s consumer protection lawsFrom 1 January 2015, Medicus College can be prevented from issuing you with a nationally recognised VET qualification or statement of attainment when you complete your course if you do not have a Unique Student Identifier (USI). If you have not yet obtained a USI you can apply for it directly at http://www.usi.gov.au/create-your-USI. If you would like Medicus College to apply for a USI on your behalf you must authorise us to do so and declare that you have read the privacy information at http://www.usi.gov.au/Training-Organisations/Documents/Privacy-Notice.pdfPlease complete Section A or Section B. Section A (You will create your own USI) Student NameI will create my own USI and advise Medicus College. I also give permission for Medicus College to verify my records by viewing them via the USI. I understand my enrolment cannot be confirmed until I provide the USI.SignatureClear SignatureSection B (Giving permission to Medicus College to create your USI) Nameauthorise Medicus College to apply pursuant to sub-section 9(2) of the Student Identifiers Act 2014, for a USI on my behalf. I have read, and I consent to the collection, use and disclosure of my personal information pursuant to the information detailed at http://www.usi.gov.au/TrainingOrganisations/Documents/Privacy-Notice.pdf. Select one of the following and attach a copy:Drivers licenceMedicare cardPassportAustralian Birth CertificateCertificate of Registration by Descent Citizenship CertificateSignatureClear SignaturePreviousNextCredit Card DetailsCard TypeExpiry DateName on CardCard NumberCCVI authorise Medicus College debit from my account/credit card.NameTotal DeditSignatureClear SignatureDate Direct DepositPayeeAccount NumberFinancial InstitutionBSB NumberPlease post your enrolment toOR bring the form to the Medicus College with your payment. By making this payment and signing, I agree to the terms and conditions of enrolling in the selected course. Issuing Certificates and/or Statements It is important that you provide the exact name you wish to have shown on any qualifications or licences issued. Therefore, it is important that you complete the particulars below in neat BLOCK letters so we can transfer the details to your documents. Any incorrect information will incur a re-issue fee if we have to print the documentation again. NameFirstMiddleLastSubmit