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Enrolment

The following Enrolment form may be used to enrol. Complete, then click submit below to send.

Download Enrolment form - PDF version

Personal Information
Name First Last
Date of Birth / DD / MM YYYY
Gender Female Male
Address in Home Country
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Address in Australia (if known)
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Contact Number
Contact Number #2
Email
Country of Birth
Nationality
Occupation
Passport
Type Of Visa

How did you hear about ICQA?
Your level of language ability
Education Details
Highest Level of Education Completed
Have you taken any other English Language Courses? (If Yes, please give us more information below) Yes No
Where
When
Type of Course
Length of Course
Have you completed any English Language Tests? Yes No
If Yes, which ones?
What was your score?
Course Details
What do you wish to enroll in? General English Course (20 hours per week) General English Intensive (25 hours per week) Examination Preparation Course IELTS (20 hours per week) Examination Preparation Course IELTS (25 hours per week) Business English (20 hours per week) Business English (25 hours per week) Others
Starting Date / DD / MM YYYY
Finishing Date / DD / MM YYYY
Total weeks of study
Accommodation
Accommodation Requirement Homestay Sharehouse Hotel Not Required
In Date / DD / MM YYYY
Out Date / DD / MM YYYY
Do you smoke? Yes No
Is there any food that you can't eat? Yes No
If Yes, details
Do you have any allergies? Yes No
If Yes, details
Travel and Transfer
Do you wish to use our Transfer Service upon arrival? (If Yes, please give us more information below) Yes No
Arrival Date / DD / MM YYYY
Arrival Time : HH : MM AM/PM
Arrival Airport
Airline
Flight Number
Overseas Student Health Cover
Student Visa Student Only
Payment Details
Enrolment Fee $ . Dollars Cents
Accommodation Research Fee
Course tuition / Fee $ . Dollars Cents
Accommodation Fee $ . Dollars Cents
Airport Transfer
Overseas Student Health Cover
Teaching Materials Fee $ . Dollars Cents
Other Fees $ . Dollars Cents
Total (in AUD) $ . Dollars Cents
Declaration
I accept the above refund policy and acknowledge that the information I have read and provided is complete and accurate. I Agree I Disagree

We usually process your enrolment application within 24 hours after you have submitted this enrolment application form. If you do not hear from us within 48 hours after you have submitted this form, please contact us on info@icqa.com.au.

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Enrolment

Personal Information

Acceptance of Offer – Student Visa Only

Education Details

Course Details

Accommodation

Travel and Transfer

Overseas Student Health Cover

Payment Details

Declaration

ICQA