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Australia Go - Client Registration From

(English Language Course)

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and then complete all sections of this form that are relevant to your situation.

Note: That we are doing research for you based on the information you are providing to us right now.   The information you provide us will help us research into the best options for you for absolutely FREE and no obligations.

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Your Personal Details

First name:

Family name:

Address:

City:

Postcode:

Country:

Phone :


(include country and area codes)

Fax :


(include country and area codes)

E-Mail:

Your Date of Birth (Day/Month/Year):

Your Gender:

Your Nationality:

Your Occupation:

Work Phone :


(include country and city codes)

Work Fax :


(include country and city codes)

Your Requirements

What type of English course do you want to do?

If you chose "Other", please give details here:

When would you like to start your English course?

How many weeks do you want to study English?

Do you want to do an English examination at the end of your course?

If you chose "Other", please give details here:

Do you have a preference for a particular City or ELICOS Centre?
(If you do, please give details):

What type of Visa will you apply for?

Your Background

What is your current level of English ?

Would you like Australia Go to assess your current level of English?

What qualifications do you have?
Please give details (include the name of the institution):

What work experience have you had?
Please give details:

How much money do you think you will need to study in Australia? (include costs of travel, fees, accommodation, living)


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What will be your source of financial support ?

Your Confirmation

Do you confirm that you are serious about studying in Australia and that you want Australia Go to assist you?

How did you find the Australia Go Web site?
What "Keyword(s)" did you use?

Please, use this space to give us any other information you think is relevant.


 
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