Académique Documents
Professionnel Documents
Culture Documents
FR
1308
No
Yes
1. Personal details
Title (Mr, Miss etc)
Male
Female
Given names
Date of birth
/
dd
Current age
/
mm
yyyy
Citizenship
Country of birth
Telephone
No
OR Yes
Current address
Telephone
Country code
Area code
Number
Country code
Area code
Number
Cell/mobile
Country code
Area code
Number
Country code
Area code
Number
Cell/mobile
Personal email
(If you are a current QUT student, all correspondence will be sent to your student email address.)
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Course code
Name of course
3. Mode of study
(please tick)
OR
OR
I understand that if I am approved to study externally I will need to seek approval for any visits to Australia from my supervisor.
I understand that I will need to travel to Australia on a Visitors Visa and that any stay will be for 3 months or less.
I understand that if I am coming to Australia for more than three months, I will need to apply for a change of mode to full time
internal studies. If this is approved I will be required to obtain a new offer, have sponsor approval (if applicable) meet any
financial requirements for the new offer, including Overseas Student Health Cover (OSHC), and travel to Australia on a student
visa. Full details of OSHC are at: www.qut.edu.au/international/preparing-to-travel-to-brisbane/health-cover.
QUT reserves the right to request further information regarding a change of mode.
4. Research details
1. Supervisor
Applicants are strongly recommended to make contact with potential supervisors at QUT prior to submitting an application. Prior contact with
your supervisor will aid the progress of your application. Please provide details of a potential supervisor with whom you have discussed your
proposed research program. Please refer to www.qut.edu.au/study/phds-and-research-degrees/finding-a-supervisor
Supervisors name
Faculty
School
Employer details: Only include employment relating to your research career. List current and previous employment and give the
following information for each position:
Employer:
Industry:
Date started and finished:
Position:
Duties:
Relevance to research:
Name of employer
Industry in which employer involved
Please indicate full-time/part-time
Title of the position held
Brief outline of duties (up to 50 words)
Please comment on the relevance of this experience to your proposed research (up to 100 words)
OR
No
No
OR
Yes
Student
What type of
visa do you
hold?
Other visa
No
OR
Yes
Visa type
No
OR
Yes
Visa type
Reason
6. Educational qualifications
Please provide details of all post-secondary and tertiary courses that you have attended or are currently studying. You must attach certified copies of
your academic results, including English translations where necessary. Original academic records or portfolios will not be returned.
Finish
Name of qualification (eg high school, A
Course completed?
yes/no/currently studying
Start
month/year
month/year or
expected completion
month/year
No
OR
Yes
No
OR
Yes
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7. How will you be funding your studies in Australia? (tick all sections that apply)
International students are required to have access to sufficient funds to cover the full cost of your stay in Australia for the duration of your studies.
Full cost includes tuition fees, study costs, and living expenses (including dependents). Please refer to the following address for further information:
www.qut.edu.au/study/student-life/life-in-brisbane/cost-of-living
Self
Tuition fees
Living costs
Other
Please attach official provisional documentation from your funding organisation; including details of the scholarship, duration of the scholarship,
scholarship value, and details (e.g. coverage of tuition fees, Overseas Student Health Cover, living costs, dependents).
What fees/costs will be covered?
Tuition fees
Living costs
Other
Name of Scholarship
Name of organisation
Living costs
Other
Other arrangement
Please attach a letter from your employer including full details and provide further details of employment and/or arrangments
NOTE: QUT reserves the right to request additional information and/or evidence supporting your financial details.
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8. English proficiency
I will take a test on (dd/mm/yyyy):
OR
I have taken an:
9. Support Services
Do you have a disability, impairment or long term medical condition which may affect your studies?
No
Yes
If yes, please attach additional information including details of support services required.
Applicant signature
Parent / Guardian signature
Date
day
/
month
year
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