Application to Enrol Fill The Form Below Step 1 of 3 33% Title(Required)-None-Mr.Mrs.Ms.Miss.Dr.OthersFamily Name(Required) Other Names(Required) Preferred Name Previous Family Name(s) Date of birth(Required) DD slash MM slash YYYY Gender(Required)-None-MaleFemalePrefer not to sayOthers....Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone(Required) Other Phone Email address(Required) Re-enter email to confirm(Required) Citizenship(Required) If not Australia, what type of visa do you hold? Country of Birth(Required) Main language spoken at home(Required) Do you have a disability, impairment or long term condition that will affect your studies?(Required)-None-YesNoAre you:(Required)-None-Non-IndegenousAborignalTorres straight islanderAborignal and torres straight islanderEmergency Contact Name(Required) Relationship(Required) Telephone(Required) Please attach a recent CV that includes details of your academic and employment history(Required)Max. file size: 512 MB.Current Employment Status(Required)-None-Full Time EmployeePart Time EmployeeEmployerSelf-Employed - Not Employing OthersEmployed - Unpaid Worker In Family BusinessUnemployed - Seeking Full-Time WorkUnemployed - Seeking Part-Time WorkOthers....What was the highest level of secondary school you completed?(Required) In which year did you complete secondary school?(Required) List the highest and/or most recent qualifications you have undertaken. Please attach a scan of each qualification's transcript. If you have more qualifications that you would like to include as part of your application, please email the details to dbl@imia.edu.au and attach a scan of each qualification.Name Of Course 1(Required) Institution(Required) Started (year)(Required) Completed?(Required)YesNoCompleted (year)(Required)Transcript(Required)Max. file size: 512 MB.Name Of Course 2 Institution Started (year) Completed?YesNoCompleted (year)TranscriptMax. file size: 512 MB.Name Of Course 3 Institution Started (year) Completed?YesNoCompleted (year)TranscriptMax. file size: 512 MB.What is the highest level of qualifications held by your parents?Parent 1(Required)-None-Postgraduate QualificationBachelor DegreeOther Post School QualificationComplete Year 12 Or EquivalentDid Not Complete Year 12 Or EquivalentParent 2(Required)-None-Postgraduate QualificationBachelor DegreeOther Post School QualificationComplete Year 12 Or EquivalentDid Not Complete Year 12 Or EquivalentIf your application to enrol is approved:Would you study:(Required) Part-time (1 subject per session, approx. 20 hours per week) Full-time (2 subjects per session, approx. 40 hours per week) Do you intend to pay enrolment fees up-front or use FEE-HELP?(Required) Up-front (payable upon enrolment each session) FEE-HELP (deferred through the Commonwealth FEE-HELP loan scheme*) ID(Required)Max. file size: 512 MB.Please upload a scan of government-issued photo ID that confirms your citizenship, such as a passport photo page, birth certificate or citizenship certificate (note: driver's license is not acceptable).Comments Please include any additional comments you would like to make about your application (optional)It may take a few moments to upload any files you have submitted when you click the 'next page' button -- please be patient. Privacy(Required)The personal information you provide on this form is protected by the Privacy and Personal Information Protection Act 1998 (NSW). You should be aware that you are providing this information of your own free will for the purpose of seeking admission to a course at the Australian Graduate School of Leadership within Torrens University. Your information will be used to assess your eligibility for admission and for the related purpose of establishing and maintaining records. We may disclose some of your information to other individuals or organisations to check the academic and other qualifications upon which your application for admission is based, to meet legislative reporting requirements, and for the administration and collection of fees. We may also disclose some of your information to the Alumni Office for the purpose of initiating contact with you. The personal information you provide will not be made available to any other person or organisation outside of Torrens University Australia or the Australian Graduate School of Leadership or for any other purpose without your consent. Your personal information will be stored for a period of six months after an unsuccessful application or six years after your course of study ceases. You may access your personal information to ensure that it is not inaccurate, irrelevant to the purposes for which it was collected, misleading, incomplete or out-of- date. You may also ask us to amend any of the information we hold about you or add comments or explanation in relation to the information we hold on you. To do any of these things, please write to the privacy officer at: privacy@imia.edu.au. I have read and understood the privacy statement above Declaration(Required)I wish to be considered for admission to the Doctorate of Business Leadership course. 1. I declare the information supplied in this application and the documentation supporting it is correct and complete. 2. I acknowledge that the provision of false or misleading information may result in the non-acceptance of this application or immediate termination of my enrolment. 3. I authorise Torrens University Australia and the Australian Graduate School of Leadership to verify any information provided by me. 4. I authorise Torrens University Australia and the Australian Graduate School of Leadership to obtain, where necessary, from any other educational institution evidence of my academic record or to seek other corroborating evidence with respect to my application. 5. I authorise Torrens University Australia and the Australian Graduate School of Leadership to release details of my academic records as requested by other educational institutions to assist and corroborate the processing of applications I may make to such institutions. 6. I understand that Torrens University Australia and the Australian Graduate School of Leadership may disclose the personal information I have given in this application to the Department of Education and Training (DET) and that DET will collect and store my personal information for use in connection with the Higher Education Statistics Collection. 7. I can view the full, current Policies and Procedures online at http://torrens.edu.au/about/policies including the Refund Policy and Procedure, Student Privacy Policy and Procedure, Deferral Policy and Procedure, Suspension and Expulsion Policy and Procedure and the Terms and Conditions of Enrolment. NB: Your application may be cancelled if you do not provide true and complete information in connection with your application, or if you make any changes to the above declaration and authority. I have read and understood the privacy statement above EmailThis field is for validation purposes and should be left unchanged. 7155022161