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On-line Application Form

POSTGRADUATE PROGRAMS | APPLICATION FOR ENROLMENT

Please complete the online form to apply for enrolment into a Chifley Postgraduate Program.

Once submitted, further instructions will be given to confirm your enrolment including required documentation. Please read the instructions carefully and contact Chifley if you require assistance.




PERSONAL DETAILS



Title *

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First Name *

First Name is required.
Last Name *

Last Name is required.
Date of Birth *

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Gender *

Gender is required.
Position

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Organisation *

Organisation is required.
Industry

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Email *

Please enter a correct email address
Tel (BH)
Please include local area code. *

Telephone number is required.
Mobile
Please include local area code. *

Mobile number is required.
Preferred correspondence address *

Preferred correspondence address is required.
Address *

Correspondence address is required.


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Suburb *

Correspondence suburb is required.
State *

Correspondence state is required.
Postcode *

Correspondence postcode is required.
Country *

Correspondence country is required.

Please select the award you wish to enrol into:

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ENROLMENT INFORMATION



Please select which study period and year you want to enrol into: *

Study period is required.
Year *

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Have you prevoiusly enrolled in the program? *

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Do you hold an undergraduate Bachelor degree?[1-refer to text below] *

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Are you an APESMA member?[2-refer to text below] *

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If yes, your APESMA number

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Do you have previous postgradute study that you wish to apply for credit with? *

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[1] Applicants without an undergraduate degree may apply through Special Entry . Please contact Chifley directly or visit Special Entry section of our website for details.


[2] APESMA members are entitled to reduced tuition fees. Visit www.apesma.com.au for more information.



ORGANISATION/MEMBERSHIP AFFILIATIONS



Please advise if you are a member/staff of these orgnisations to receive your member affiliation rate.

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Membership number (if applicable)

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How did you find out about this course?

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Please specify

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Were you referred to the program by a graduate or current student? *

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If YES, please provide their:

Student ID

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First Name

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Last Name

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Email

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QUALIFICATION DETAILS (HIGHEST LEVEL ATTAINED)



Qualification Name (e.g. BEng) *

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Qualification Level (e.g. Bachelor) *

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Year Conferred *

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Field of Study (e.g. Engineering) *

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Discipline (e.g. electrical) *

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Name of Institution *

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Country Qualification Attained *

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DEEWR STATISTICS

DEEWR - Department of Education, Employment and Workplace Relations

It is a legal requirement for anyone wishing to undertake study with an Australian education institution to provide these details. The data collected is then used by DEEWR for statistical & taxation purposes.

These details are NOT provided to any third party.




Education Statistics



Did you complete Year 12? *

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If YES, in what year did you complete Year 12?

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What is your highest educational attainment prior to commencement of this course? *

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What year did you complete the above course? *

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Please select citizenship/residency that applies to you *

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If Other, please specify

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If you are a permanent resident of Australia please specify the date you obtained Permanent Resident Status



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Are you of Aboriginal descent? *

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Are you of Torres Strait Islander descent? *

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Please select one of the following if you have a disability, impairment or long term medical condition *

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Permanent home address postcode *

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State country for permanent home address *

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Current residence postcode *

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State country for current residence *

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Country of birth *

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If born overseas, indicate your year of arrival in Australia

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Language spoken at home

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Year 12 postcode (in Australia)

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State country if Year 12 residence is overseas

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PRIVACY STATEMENT




Chifley respects your privacy and strictly controls use of personal information. The information you provide on your enrolment will be used in administering the Chifley Business School program, which involves the use of external service providers. Where it is necessary to involve a third party service provider, Chifley will ensure that a confidentiality agreement is in place to protect your personal details, and will only supply details which are necessary to provide the agreed service. Your enrolment will be an indication of your consent to utilise any necessary information to administer the program by Chifley and these third party service providers. You may obtain details of your personal information held by Chifley or our detailed privacy statement by contacting the Privacy Officer on (03) 9695 8800 or visiting our website at ww.apesma.asn.au.

Declaration *

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