Australian Institute of Family Counselling Application for Enrolment Form (ISP) Note: Information contained in this document is utilised in accordance with aifc Privacy Policy 1. Personal Details (Please choose by placing an X in the boxes that apply to you) Title: Mr Mrs Ms Miss Other: Gender: Male Female Date of Birth: Surname: Given Names: Nationality: USI: 2. Contact Details Address (Home Country) Address: Phone: Fax: Email: Address (Australia) Address: Suburb: State: Postcode: Phone (Home): Phone (Work): Mobile: Fax: Email: Correspondence Address: (Address where you would like mail to be sent) Correspondence Address: Home Country Australia Agent Address (Part 5) Emergency Contact Details Name: Address State: Phone (Home): Mobile: Email: Postcode: Phone (Work): Relationship: Document Name: Application for Enrolment ISP Date: 09/2016 Review Date: 09/2017 Page 1 of 8
3. Passport Details Australian Institute of Family Counselling Passport Status: Issued Pending Passport Issued By: Passport Number: Passport Expiry Date: A certified true copy of your original documents must be provided as part of your application Verified By (Print Name): Date: Signed: 4. VISA Details VISA Type (If Held) Student Visitor Working Bridging VISA Status: Issued Pending VISA Number: VISA Expiry Date: Are you in Australia now: Yes No If you do not currently hold a valid VISA please complete the following: Location of Lodgement: Country City Date of Intended Application: A certified true copy of your original documents must be provided as part of your application 5. Education Agents Education Agent: Yes No Name: Address: Phone (Home): Mobile: Email: Phone (Work): Fax: Document Name: Application for Enrolment ISP Date: 09/2016 Review Date: 09/2017 Page 2 of 8
6. Overseas Student Health Cover Australian Institute of Family Counselling OSHC Arranged Yes (Part A) No (Part B) Part A Insurer Details Name of Insurer: Member Number: Date of Expiry: Part B - aifc to produce a quote (you will still have to make the final arrangements yourself) Cover Type Single: 3 Months 6 Months 9 Months 12 Months Cover Type Family: 3 Months 6 Months 9 Months 12 Months 1. The Australian Government requires all persons entering Australia on a Student Visa to have Overseas Student Health Cover (OSHC). 2. The length of your OSHC MUST cover the total length of your course(s) 7. Education Details What is the last School / College / University that you attended? What is your highest level of education COMPLETED? 8. English Language Proficiency (Please choose by placing an X in the boxes that apply to you) Assessment Type Score Date Achieved IELTS TOEFL Other Not Required. English is my first language: Yes No Do you need any additional support? Yes No Specify: 9. Disability Status (Please choose by placing an X in the boxes that apply to you) Do you suffer from any physical / mental disability that may affect your participation in the course? Yes No Go to Question 9 Disability, Impairment or Long-Term Condition Hearing / Deafness Physical Intellectual Learning Mental Illness Acquired Brain Impairment Vision Medical Condition Other Not Specified Document Name: Application for Enrolment ISP Date: 09/2016 Review Date: 09/2017 Page 3 of 8
Australian Institute of Family Counselling 10. Qualification Selection (Please choose by placing an X in the boxes that apply to you) Qualification / Course Name Yes No Diploma of Counselling (Christian) 1046NAT - CRICOS Code: 085356B Advanced Diploma of Counselling and Family Therapy (Christian) 10487 NAT - CRICOS Code: 085357A Graduate Diploma of Counselling and Integrated Psychotherapy (Spiritual) 10134NAT - CRICOS Code: 091740K Note: Details of Intake Numbers can be obtained from our Course Schedule or by visiting our website: www.aifc.com.au 11. Recognition of Prior Learning / Credit Application Would you like to make an application for RPL / Credit: Yes No Note: Speak to the Welfare Officer if you intend to apply for RPL or Credit Transfers Intake year 12. Study Reason Please indicate the reason you would like to complete this qualification To get a job To start my own business To get a better job or promotion I want extra skills for my job For personal interest or self-development To develop existing business To try for a different career It is a requirement of my job To get into another course of study Other reasons 13. Study Periods Your tuition fees must be paid by Semester. You are responsible for payment by due date stated on your invoice. If you have any queries in regards to your invoice please contact the Accounts Manager on 02 642 5111 or email: accounts@aifc.com.au. All students need to be aware that fees are not refundable after the ISP census date for the semester. Term 1 Term 2 Term 3 Term 4 2017 7 March 6 May 16 May 8 July 25 July 23 September 3 October 2 December 2018 6 March 5 May 15 May 7 July 24 July 22 September 2 October 1 December 2019 5 March 4 May 14 May 6 July 23 July 21 September 1 October 30 November 14. Accommodation Requirements Have you arranged suitable accommodation: Yes No Any other additional information: Document Name: Application for Enrolment ISP Date: 09/2016 Review Date: 09/2017 Page 4 of 8
15. Church Affiliation Australian Institute of Family Counselling Name of Church Are you involved in any ministry? If so, please describe: Church Denomination Name of two referees: Church Leader Position Phone Address Church Leader Position Phone Address 16. Payment Details Applications submitted to aifc must be accompanied by a NON REFUNDABLE Application Fee of AUD250. This fee applies to all applications directly to aifc or through aifc s agents. Payment details must be included with this application form. Bank Cheque for AUD250 made payable to the Australian Institute of Family Counselling LTD Bank Transfer for AUD250 made payable to aifc: Account Name: Account Number: 10229965 Bank Name: BSB: 062 904 Bank Address: BIC/SWIFT Code: Australian Institute of Family counselling Commonwealth Bank of Australia Hibberson St Gungahlin ACT 2912 Australia CTBAAU2S Preferred method of payment for TUITION FEES as shown on the bottom of the invoice 17. Course Cost 2016 Diploma of Counselling (Christian) 1046NAT - CRICOS Code: 085356B $ 9600.00 Advanced Diploma of Counselling and Family Therapy (Christian) 10487 NAT - CRICOS Code: 085357A $ 11500.00 Graduate Diploma of Counselling and Integrated Psychotherapy (Spiritual) 10134NAT - CRICOS Code: 091740K $ 14000.00 18. Application Checklist Have you: Completed all sections of this application Attached certified true copies of your VISA Attached certified true copies of your Passport Attached certified true copies of your qualifications Attached certified true copies of your English Proficiency Attached any other relevant documentation Completed the payment details Read and signed the declaration Attached four (4) x Passport Photos Document Name: Application for Enrolment ISP Date: 09/2016 Review Date: 09/2017 Page 5 of 8
Australian Institute of Family Counselling 19. Extra Requirements for the course Self Assessment Checklist Please indicate below which statement best describes you: I have never used a computer I have rarely used a computer and I am not comfortable using one yet Additional Information: Do you have a computer at home? Yes No Are you comfortable using the internet? Yes No Do you have high speed (e.g. ADSL, ADSL+, NBN) internet access at home? Yes No I have rarely used a computer and I am not comfortable using one yet Please rate your ability to send, receive emails with attachments? Please rate your ability to copy and paste text from one document to another Please rate your ability to save a document into a relevant folder using a meaningful name Please rate your ability to format paragraphs including adding and editing bulleted or numbered lists Please rate your ability to capture photos or video and upload them to a location on the web TERMS AND CONDITIONS Fees and Charges Expert Very Well Expert Very Well Expert Very Well Expert Very Well Expert Very Well Competent Average Competent Average Competent Average Competent Average Competent Average A NON REFUNDABLE application fee of AUD250 is processed as part of your Application for Enrolment Payment of fees must be made by the due date, otherwise penalties may apply. Refunds Refunds are only available under certain conditions To apply for a refund you must submit a Form and any other supporting documentation Course Fees are not transferrable to another provider All processed refunds will be paid to the nominated back account in Australian Dollars only A full detail of Refunds can be obtained by requesting a copy of the Refunds Policy You have the right to appeal any decision made regarding the refund process. Please refer to the refund and withdrawal policy on aifc website Document Name: Application for Enrolment ISP Date: 09/2016 Review Date: 09/2017 Page 6 of 8
Australian Institute of Family Counselling Table of Refunds Type Timeframe Amount Refunded Documents VISA Refusal At any time VISA Renewal Refusal After course has commenced Nil VISA Breach At any time Nil All FEES minus the NON REFUNDABLE application fee of AUD250 Proof of VISA Refusal Proof of VISA Refusal Proof of VISA Refusal Greater than 28 days before commencement of the course All FEES minus the NON REFUNDABLE application fee of AUD250 minus AGENT Commissions Paid Letter of Offer DSC Form Withdrawal, Transfer or Enrolment Cancellation Less than 28 days before commencement of the course 50% of FEES minus the NON REFUNDABLE application fee of AUD250 minus AGENT Commissions Paid Letter of Offer DSC Form After the course has commenced Nil Nil Default by aifc Full Refund Nil COMPLAINTS AND APPEALS Whilst studying at aifc you have the right to access the Complaints and Appeals process at any time. You shall be afforded 20 days to access this process, otherwise any Complaint or Appeal will be taken as being accepted by you VISA REQUIREMENTS The Australian Government has specific guidelines for the issue and management of student VISA s. The failure to comply with these conditions may result in your VISA being revoked at you returned home. As an education provider, aifc has the responsibility to ensure you maintain a satisfactory rate of Course Completion and Attendance. aifc will monitor this and advise you if you are failing to meet to the minimum requirements. aifc is required to report any issues relating to this to DIAC. Suspension or Cancellation of Course aifc has specific guidelines that meet the requirements of the National Code and ESOS Act of the Suspension and Cancellation of student enrolments. If a student s enrolment is Suspended or Cancelled for any reason, then aifc is required to inform DIAC of this at the earliest available opportunity. Aifc have the right to cancel the course at any time and students will receive a full refund of all fee paid. The student is also required to contact DIAC to ascertain any changes in their VISA conditions. Credit Transfer / Recognition of Prior Learning Students are encouraged to apply for Credit Transfer or RPL prior to enrolment and to request an application kit where necessary: Document Name: Application for Enrolment ISP Date: 09/2016 Review Date: 09/2017 Page 7 of 8
Privacy Declaration Name: Signature: Date: Australian Institute of Family Counselling - Where Credit Transfer or RPL is granted before the issue of a VISA, the course duration will be indicated on the Confirmation of Enrolment (CoE), - Where Credit Transfer or RPL is granted after the issue of a VISA, the amended course duration will be reported via PRISMS within 14 working days and a new COE will be issued. Students are required to submit the Credit Transfer or RPL Application Kit in order to have the Credit Transfer or RPL formerly assessed. We will not disclose any information that we gather about our students to any third party. We use the information collected only for the services we provide. No student information is shared with another organisation. If student information is required by a third party we will obtain written consent from the relevant student prior to release of any information. For more details of our Privacy policy, please visit the aifc website Should students seek access to their information we have a documented procedure requiring authorisation before this can occur. I understand the Terms and Conditions, the Privacy Policy and the Cancellation and Refund Policy of aifc and confirm that I have been fully advised of the fees, cancellation and refund conditions and conditions of enrolment and I agree to be a student at aifc. All enrolments are confirmed in writing before the course starts, giving details of the course start time and any requirements for the course. In the unlikely event you do not receive confirmation of a course prior to the commencement date, please contact us immediately. I confirm that I understand the payment system of the required tuition fees as outlined in the information on course fees and I agree to comply. I also confirm that I am fully aware of my financial obligations. I therefore accept all responsibility for my fees, tuition and personal expenses incurred during my involvement with aifc. In the event of an emergency in which I am rendered unconscious and my nearest responsible relative or guardian cannot be contacted, I hereby agree to treatment from a medical expert as deemed necessary. I understand that some criminal offenses will exempt me from being able to practice in this profession and gain membership to accredited counselling associations. I give permission to aifc head office, to use any photographic, imaging or written material in regards to myself in promotional and marketing media. I do hereby release aifc, its agents, employees and volunteers from any liability whatsoever arising out of any injury, damage or loss which may be sustained by me or other persons during my course of involvement with aifc. I have carefully read and taken the time and appropriate advice to understand all the information included and accepts the requirements details in the International Student Pack and I agree to accept all conditions contained therein and I agree to abide by all of the requirements stated. I declare that all the information contained herein is true, correct and complete to the best of my knowledge. I have carefully read and taken the time and appropriate advice to understand all the information included and accepts the requirements detailed in the aifc Student Handbook and the International Information Pack. I declare that to the best of my knowledge, the information I have supplied is accurate and complete in every detail. Document Name: Application for Enrolment ISP Date: 09/2016 Review Date: 09/2017 Page 8 of 8