English Application Form

Mackintosh | Courses | English Application Form

ENGLISH APPLICATION FORM

Please complete the form below in full and check it for accuracy
We will reply to you very shortly
We will request that you send further supporting documentation where required
Required details are marked with an asterix *

Course Selection


View English Course Duration and Dates	Course Duration	Course Start Date
General English
English for Academic Purposes (EAP)

Personal Details

Title *

Given Name *

Family Name *

Gender *

Male Female

Date of Birth *

Nationality *

Country of Birth *

Contact Details

Mailing Address in Australia or Overseas

Street Address *

Suburb / City *

State / Postcode *

Country *

Home Phone *

Mobile Phone

Fax

Email Address *

Educational Background

Highest Level of Education Completed

Name of Qualification

School / Institution Attended

Name of Current Institute
(if currently studying)

When do you expect to finish

English Language Proficiency

IELTS / TOEFL Score

Other (please give details)

Passport and Visa Information

View Overseas Student Health Cover (OSHC) Prices Here

What type of visa do you require?

Student
Visitor
Work Sponsorship
Other

(if other please specify)

Do you have Overseas Student Health Cover (OSHC)? *

Yes No

If you have OSHC please provide details

Do you require Mackintosh to arrange OSHC cover for you?

Yes No

If you require OSHC cover how long will you need it for?

Passport Number *

Passport Expiry Date *

Accommodation

View Accommodation Prices Here

Do you need help finding accommodation? *

Yes No

If you need accommodation what type of accommodation would you like?

Homestay

Single Room
Shared Room

Length of Stay

weeks

Do you Smoke?

Yes No

Do you have any ongoing medical conditions, or dietary requirements?

Yes No

(If yes please provide details)

Airport Reception

View Airport Reception Prices Here

Do you require airport pickup? *

Yes No

If you do require an airport pickup please fill in the details below

Flight Date

Flight Time

Airport

Flight Number

Payment Method

For information on Mackintosh College Refund Policy Click Here

How will you be Paying *

Employment Assist

For Information on Employment Assist Click Here

Do You Require Employment Assist

Yes No

How did you hear about Mackintosh College

Agent
Exhibition
Family / Friend

School / Seminar
Newspaper
Internet

Additional Comments

Application Agreement

I have read and understood the student handbook and refund policy of Mackintosh International College Australia. I understand that by agreeing to this document I am bound by the rules and regulations set by Mackintosh International College Australia.

* I (being the student of 18 years or older) herby declare that the information being submitted in this application form is true and correct and I have read and understood the student handbook and refund policy.

I Agree I Do Not Agree