Personal Information

Family Name
Given Name
Date of Birth	DD/MM/YY      Male Female
Address in Home Country
City
Country
Address in Australia (if known)
City
Home Phone
Work Phone
Fax
Email Address
Country of Birth
Nationality
Occupation
Passport
Type Of Visa	Student Working Holiday Tourist
How did you hear about ICQA?
Indicate your level of language ability	Beginner Elementary Low Intermediate High Intermediate Advanced

Education Details

Highest Level of Education Completed University College High School
Have you taken any other English Language Courses? Yes No
If Yes -	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 Speaking Intensive Course Academic English Secondary Studies Preparation Course Farm Training Course Teacher's Homestay Others
Full Time(25 Hours / Week) Part Time(20 Hours / Week)

Starting Date	Day: Month: Year:
Finishing Date	Day: Month: Year:
Total weeks of study:	weeks

Accommodation Requirement

Home Stay Share House Hotel Not Required
In Date	Day: Month: Year:
Out Date	Day: Month: Year:
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? Yes No If yes, please complete the following information:
Arrival Date:	(DD/MM/YY)	Arrival Time:	(HH/MM)
Arrival Airport:
Airline:		Flight Number:

Overseas Student Health Cover

Student Visa Student Only

3 months 6 months 9 months 12 months

Payment Details

Enrolment Fee		Accommodation Research Fee	$0.00 $154.00
Course tuition / Fee		Accommodation Fee
Airport Transfer	Not Required One way $77.00 Return $154.00	Overseas Student Health Cover	Not Applicable $0.00 3 Months $74.00 6 Months $148.00 9 Months $212.00 12 Months $274.00
Teaching Materials Fee		Other Fees
Total (in $AU)

Conditions of Enrolment and Refund Policy

Course Related Fees 

• Enrolment fee is not refundable.
• Tuition fees are fully refundable if a visa application is rejected.
• Enrolment fee is not refundable if a visa application is rejected.
• Before arrival in Australia tuition fees will be fully refundable if a written application is received 28 days or more before the student’s agreed starting date.
• If an application for refund is received less than 28 days before the agreed starting date, a cancellation fee equivalent to 4 weeks tuition will be charged.
• There will be no refund of tuition or enrolment fees after the student has commenced the course.
• There is no refund for public holidays that fall during a student’s course

 Refund Policy - Homestay and Airport Pickup Fees

• Accommodation placement fees are not refundable.
• If a student’s visa application is rejected, homestay fees and airport pickup fees will be refunded.
• ICQA will find an alternative homestay for a student if the initial placement is found to be unsuitable. However, the student must give a minimum of two weeks notice of cancellation of Homestay otherwise a charge equal to 2 weeks homestay fee will be deducted.
• Students must give a minimum of 24 hours notice for cancellation of airport pickup otherwise the student will have to pay the airport pickup charge.
• Students must give a minimum of 24 hours notice for a change of date of airport pickup or the student will have to pay another fee.

Payment of any applicable refunds will be made to the person or company which made the original payment to ICQA, within 4 weeks of ICQA receiving a written application. All course monies including compulsory charges will be refunded if the course is not able to be delivered by ICQA. If ICQA is unable to deliver a course, a refund will be provided no later than 2 weeks after the student receives written confirmation that the course has been cancelled. All refunds will be calculated and sent in Australian dollars. This agreement and ICQA’s grievance resolution procedures do not remove the right to take further action under Australia ’s consumer protection laws.

Also this policy does not circumscribe the student’s right to pursue other legal remedies.

Grievance Procedures

To download the Grievance Procedures in Adobe PDF, please click here.

Declaration

I accept the above conditions of enrolment and acknowledge that the information I have read and provided is complete and accurate.