Application for Admission to CHC51708 Diploma of Counselling - Cengage.

Section A - Personal Details

* Indicates required field
1.
Title:
First name: *
Other name:
Family name: *
Previous names:
Preferred name:
2. Date of birth: *
3. Gender: Male Female
4.
Tel (home): *
Tel (other):
Mobile:
5.
Fax:
6.
Email: *
7.
Permanent home address: *
Suburb: *
State: *
Postcode: *
Country: *
8.
Postal address:
(if different)
Suburb:
State:
Postcode:
Country:
9.
Term address:
(if different to
permanent home address)
Suburb:
State:
Postcode:
Country:

Section B - Ethnicity

10. Are you of Aboriginal or Torres Strait Islander Origin? *
No
Yes, Aboriginal
Yes, Torres Strait Islander
Yes, both Aboriginal and Torres Strait Islander
11. Were you born in Australia?*
Yes
No
No - In which country were you born?
What is your year of arrival in Australia?

Section C Citizenship/Visa

12. Are you an Australian Citizen? *
Yes
No
No - Are you the holder of a permanent humanitarian visa?
Yes
No
No - Are you an Australian Permanent Resident or New Zealand Citizen?
Yes
No
No - Please provide your visa details below:
VISA TYPE:
VISA NO:
VISA EXPIRY DATE:

Section D - Language

13. Is English the language spoken at your permanent home
residence?*
Yes
No
No - Please specify the language spoken at your permanent home residence:
14. Will you need help with English during the course of your studies?*
Yes
No
15. If your secondary and/or tertiary education was undertaken in a language other than English, please enter your IELTS ** score:


(Please provide a certified ** copy of your IELTS certificate or a certified copy of your transcripts from the Australian Centre for Language or the Universal English College)
  ** IELTS: International English Language Testing System. Certified: An authorised person must sign on your copies that they are true and correct, print their name and position and if possible affix an official stamp.

Section E - Disability

16. Do you have a disability, impairment or long term medical condition which may affect your studies?*
No
Yes
Yes - Please indicate the area/s of impairment:
Hearing
Learning
Mobility
Vision
Medical
Other (please specify):
17. Would you like to receive advice on support services, equipment and facilities which may assist you?
Yes
No

Section F - Education, Qualifications & Employment

18. What is your highest completed secondary school level?
  Year 10 or lower Year 11 Year 12
Last year attended
(Eg 2004)
Name of school/college
State/Country
Student ID Number
(if available)
N/A
N/A
Academic Result
(if available)
N/A
N/A
19. Have you attempted any further qualifications?
No
Yes
Yes - Please provide details in the following table:
Qualification Institution Completed? Last Year Attended
Advanced/Tech Certificate Yes No
Trade Certificate Yes No
Certificate (other than above) Yes No
Diploma/Advanced Diploma Yes No
Undergraduate Degree Yes No
Postgraduate Certificate
/Diploma		 Yes No
Masters Yes No
PhD or Doctorate Yes No
20. What is your current occupation?
21. Which of the following best describes your current employment status? (choose one only)*
Full-time employee
Employed unpaid worker in a family business
Part-time employee
Unemployed seeking full-time work
Self-employed not employing others
Unemployed seeking part-time work
Employer
Not employed not seeking employment

Section G - Course & Module Preferences

22.

Course and Mode*
Diploma of Counselling

Please enter the year, select the term you wish to enrol in and the number of modules you wish to take in that term.

Year you wish to commence:

Term Study Load Modules
Term 1 1 Module E0004 Module 1 Facilitate the Counselling Process
Term 2 2 Modules E0005 Module 2 Counselling Interview Skills
Term 3 3 Modules E0006 Module 3 Counselling Theories
Summer School  
23. Are you applying to study under Mature Age Special Entry Provisions (21 years or over)?*
Yes No
24. Are you applying for Recognition of Prior Learning ** (Advanced Standing)?
Yes - A separate Advanced Standing application is required- please contact ACAP for more information.
No
** Recognition of Prior Learning: For People who have developed competencies through previous experience of study download the Advanced Standing application form.
25. In order to assess your application, please write a brief statement (at least 150 words) describing how your interest in the course relates to your career aspirations.*
26. How did you hear about Cengage? *
Other:

Section H - Payment Options

  I would like to defer my fees through FEE-HELP **.
Please send me a "Request for FEE-HELP Assistance" form.
My completed "Request for FEE-HELP Assistance" form has been posted to ACAP in Sydney.
I will fill or have filled it in online.

I would like to defer a portion of my fees through FEE-HELP and pay a portion upfront.
Please send me a "Request for FEE-HELP Assistance" form.
My completed "Request for FEE-HELP Assistance" form has been posted to ACAP in Sydney.

I would like to pay my Term fees up front. You will receive an invoice for your Term fees.
  ** FEE-HELP: An Australian Federal Government Loan given to eligible fee paying students to help pay part or all of their tuition fees.

Section I - Application Checklist

  To complete your application for admission, please ensure that the following items are posted to the address below:
  • Completed request for FEE-HELP Assistance form (if applicable).
  • Certified copy of qualifications attained, including English translation if applicable (postgraduate course applicants only).
  • Certified copy of proof of age such as a birth certificate, passport or drivers license (undergraduate course applicants only).
  • Certified copy of your IELTS results or a certified transcript from Australian Centre for Languages or Universal English College (if English is not spoken at your permanent home residence).
  • An up-to-date CV (if applying for the Master of Applied Social Science)
  • If you are applying for Recognition of Prior Learning, a separate application is required (download the Advanced Standing application form). Please contact student administration for more details.

Section J - Privacy Statement

ACAP collects, stores and uses personal information only for the purposes of administering prospective, current and graduate student admissions, enrolment and education. The information provided is confidential and will not be disclosed to third parties without your consent, except to meet government, legal or other regulatory requirements. For more information please refer to the ACAP privacy policy.

Section K - Declaration

Important: This form contains and refers to contractual terms.

I wish to be considered for enrolment as a student in a course at ACAP. I declare that all information submitted is correct and complete and that I can and will produce to ACAP originals of all submitted documentation on request.

I authorise ACAP to obtain further academic information or official student records from any educational institution or recognised educational qualifications assessment body necessary and/or, where my work experience is relevant, to verify my employment history for the purposes of making an informed decision about my application.

I authorise ACAP to release any personal information held about me to the Department of Education, Employment and Workplace Relations (DEEWR), should I enrol at ACAP. DEEWR may disclose this information to the Australian Taxation Office.

I acknowledge that ACAP reserves the right to vary or reverse any decision regarding admission made on the basis of incorrect, incomplete or fraudulent information.

I am aware that the ACAP Student Handbook is available on-line at www.acap.edu.au/Pdf/StudentHandbook.pdf. By signing this form I acknowledge that I have read and understood the policies, procedures and terms set out in the ACAP student Handbook and I agree to be bound and abide by the policies, procedures and terms set out in the Student Handbook, as amended from time to time. I acknowledge and agree that the acceptance of my application by ACAP is conditional upon my agreement to be bound and abide by the policies, procedures and terms set out in the Student Handbook, as amended from time to time.

I AGREE Yes No *

POST, EMAIL OR FAX ANY ADDITIONAL DOCUMENTS TO:

Postal address: Cengage Education, Locked Bag 900, Artarmon NSW 1570
Email: auste.studentenrolment@cengage.com
Fax: 02 9433 3666
Phone: 1300 650 011
Please contact ACAP Admissions if you require further forms or help completing your application.
If I were to say anything to those thinking about studying at ACAP, it would be this: of all the colleges and institutions that promise you the world, when it comes to learning, ACAP offers comprehensive programs, experienced, professional trainers, flexibility and excellent resources.

I shopped around for a good learning institution and the more I looked, the more ACAP came out on top.
Michael Adamantidis
Registered Psychologist