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Enrolment Form

Please fill in this form in English
Fields marked with an asterisk * are required.

Student Information

Given Name *	Only in English !!
Family Name *	Only in English !!
Gender *	Male Female
Date of Birth *
Postal Code *
Nationality *
Address *
Suburb/Town *
State/Province *
Home Phone *	ex. 012-345-6789
Mobile Phone	ex. 012-345-6789
FAX Number	ex. 012-345-6789
Email *
Type of VISA *
English Level

Course Information

First Course
Course *
Terms *	weeks days
Starting Date *	ex. 30 / 08 / 2008 (DD/MM/YYYY)
Endding Date *	ex. 30 / 08 / 2008 (DD/MM/YYYY)

Second Course
Course
Terms	weeks days
Starting Date	ex. 30 / 08 / 2008 (DD/MM/YYYY)
Endding Date	ex. 30 / 08 / 2008 (DD/MM/YYYY)

Accommodation

First Preference
Accomodation Type *	None(Share) Lodge-Single Lodge-Twin Homestay-Booking Homestay-Party
Moving in *	ex. 30 / 08 / 2008 (DD/MM/YYYY)
Moving out *	ex. 30 / 08 / 2008 (DD/MM/YYYY)

Party Homestay Only
Relationship	Nobody(H/S) Friend Mother Father Child Husband Wife
Given Name	Only in English !!
Family Name	Only in English !!

Second Preference
Accomodation Type	None(Share) Lodge-Single Lodge-Twin Homestay-Booking Homestay-Party
Moving in	ex. 30 / 08 / 2008 (DD/MM/YYYY)
Moving out	ex. 30 / 08 / 2008 (DD/MM/YYYY)

Precondition for Accommodation

Do you smoke?	Yes No
Do you like children?	Yes No
Do you like pets?	Yes No

Pick up and Drop off (at Cairns International Airport)

Do you need to pick up? *	Yes. No.
Flight Number	ex. QF060 If you don't have an airline ticket yet, please leave the following fields blank.
The time of arrival	Date ex. 30 / 08 / 2008 (DD/MM/YYYY) Time :

Do you need to drop off ? *	Yes. No.
Flight Number	ex. QF060 If you don't have an airline ticket yet, please leave the following fields blank.
The time of departure	Date ex. 30 / 08 / 2008 (DD/MM/YYYY) Time :

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Cairns, Queensland, AUSTRALIA

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