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 PERSONAL INFORMATION

First Name:
Surname:
Date of Birth:
Address:
 
Telephone:
Fax:
E-Mail:
Fathers Name:
Mothers Name:


 CURRENT EDUCATIONAL INFORMATION

Highest Qualification:
Name of Qualification:
Name of University Studied at:
Percentage:
Year Completed:


 INTENDED STUDY INFORMATION

Intended Courses in Australia:
Intended Month & Year of Commencement:


 WHICH COMPANIES / INSTITUTIONS ARE YOU INTERESTED IN HEARING MORE FROM (please tick)

Student Services International (SSI)
Universal Migration Services
University of Ballarat
Swinburne University of Technology
Eltham Collage
ANZ Banking Group
Other
Please Indicate (if other)  
  Once you have completed this form, click the Submit button. Your assessment will be sent to Universal Student Services for processing.
       

*For security reasons you may prefer to fax, phone or mail the details. If doing so please advise when requesting an assessment.

*All the information provided hereon will be considered in the strictest of confidence and is subject to privacy laws.
 
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