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Regional Manager/Agent’s StampOFFICE OF ADMISSIONSBond UniversityUniversity Drive, RobinaQueensland 4229 AustraliaPh: 61 7 5595 1024Fax: 61 7 5595 1015Web: bond.edu.auTo apply online visitbond.edu.au/applyCRICOS CODE 00017BApplication for Undergraduate AdmissionPersonal Details1TitleGiven name(s)Surname or family namePreferred name (or nickname)Date of birthMaleFemaleCitizenshipDayMonthYearCountry of birthIf you are not an Australian citizen, do you hold a permanent resident visa?If yes, please provide a copy of your visa with this application.NoPermanent home address (applicants address only)Address for correspondence (applicants address only)StateYesStatePostcode/Zip codePostcode/Zip codeCountryCountryPhone (include area code)Fax (include area code)After hours/HomeEmail (please list applicant personal email)MobilePlease print clearly – your email address will be used for all correspondence regarding theprocessing of your application.Business hours/Work2Preferred course of studyDegree – Preference 1 (if combined degree list as one preference ie. BA/BIT)Degree – Preference 2 (if applicable)Major/area of specialisationMajor/area of specialisationCommencement semester (tick one box only and insert appropriate year)Do you intend to study on a full-time or part-time basisJanuary 20May 20September 20Office Use OnlyDATE RECEIVEDENTEREDIntlIntlFull-timePart-time

3Special requirementsDo you suffer from any conditions – medical or otherwise, which will require Bond University to make special provision for you,either academically or with regard to on-campus accommodation? If yes, you are required to provide specialist documentationwith your application.YesNo4High school/matriculation studiesGive details of your high school studies (eg. Senior, HSC, “A” Levels, Senior High School). Certified copies of results must be included.Year(s)Name of qualificationSchool or collegeState or countryTertiary EntranceScore (OP/TER etc)eg.2004-2005SeniorMarymont CollegeQueenslandOP 4If you are currently enrolled, indicate when you expect to qualify for your award5MonthYearTertiary education historyProvide details of any tertiary (higher education) studies below.Year(s)Name of qualificationSchool or collegeState or countryF/T or P/TCompletedeg.2003-2005Bachelor of ArtsUniversity of SydneyNew South WalesF/TYesIf you are currently enrolled, indicate when you expect to qualify for your award6MonthYearEmployment historyPlease provide details of your employment history and briefly describe your duties. Mature age applicants must attach aseparate detailed resume.Year(s)7EmployerPosition/nature of dutiesF/T or P/TOther interests and activitiesGive details of any extra curricular activities such as sporting or community activities in which you have been involved.

Credit application for prior study8Do you wish to apply YesNoThe University will award credit for previous studies provided; the subjects have been successfully completed, the subjects meetthe requirements of the Bond University degree and were completed at a recognised tertiary institution.In order to have your credit application assessed, you must include the following:a certified copy of your academic transcript, including the final results for all of the relevant subjects full course/subject descriptions for each of the relevant subjects (except in cases where an articulation agreementwith Bond already exists, see below)a list of subjects currently being undertakenArticulationAre you are applying for credit via an articulation agreement?YesNoPlease provide name of institution that has the agreement with Bond UniversityYour career ambitions and goals9The following questions have no ‘correct’ answer, but may be helpful in the processing of your application. These questions are abouthow you see your future. Please type, or write clearly. Attach a separate sheet if more space is required.What are your future goals and ambitionsParents Details10Mother’s nameFather’s nameAddressAddressStatePostcode/Zip codeStatePhone (include area code)Phone (include area code)MobileMobileEmailEmailPostcode/Zip codeThis information is being collected so that Bond can extend updates, news and event invitations to parents of Bond students. By supplying this information, parents may also be informedand invited to mark student achievements such as academic awards and graduation by making gifts to the University in commemoration of these important events.11How did you find out about Bond University?FriendAdvertisementBond websiteIn-school visit by Bond staffOther student or graduate of Bond UniversityCareer AdvisorBond Open DayEducation exhibition (specify)Agent (specify)

12Privacy Collection StatementBond University (‘BU’) may collect personal information about you, including: the information on this form; information provided by your nominated next of kin in relation to this application; and information on other forms or documents requested by, and provided by you or other educational institutions to BU.BU collects this information for the purpose of: assessing your application; providing services to you;unless you indicate that you do not wish BU to use your personal information for this particular purpose by placing atick in the adjacent box, providing you with information about other services that BU offers that may be of interest toyou; facilitating BU’s internal business operations, including the fulfilment of any legal requirements; analysing BU’s services and customer needs with a view to developing new and/or improved services; andunless you indicate that you do not wish BU to use your personal information for this particular purpose by placing atick in the adjacent box, providing you with promotional information about BU.In the case of visa details, BU is required to collect this information pursuant to Australian Immigration Laws.BU may disclose personal information about you to: service providers, who assist BU in operating its business, however, these service providers are required to comply withBU’s privacy policy in how they handle your personal information; a purchaser of the assets and operations of BU’s business, providing those assets and operations are purchased as agoing concern; its related entities; in the case of untrue or misleading information, the Australian Vice-Chancellors Committee (’AVCC’) or any AVCCmember institution; in the case of an emergency involving you, your next of kin; and your agent, whose details appear on the front of this form, and/or your next of kin for the purpose of processingyour application.If the personal information you provide to BU is incomplete and/or inaccurate, BU may be unable to process this applicationand/or be unable to provide you with the services you are seeking.You may access the personal information BU holds about you in accordance with BU’s privacy policy.13DeclarationI understand that it is my responsibility to provide all documentation requested by the Office of Admissions and authoriseBU to obtain, where necessary, any further information from my nominated next of kin and the appropriate educationalinstitutions.I hereby declare that to the best of my knowledge all information submitted or made available by me to BU, whether in relationto any course of study or otherwise, is true, accurate and complete. If any information is considered to be untrue or misleadingin any respect, I consent to the collection, storage and disclosure by BU, the AVCC, or any AVCC member institution of arecord of any such information or any other irregular activity. I understand that any record stored or disclosed according tothis system may contain personal details about me from which I may be identifiable.I understand that BU reserves the right at any stage to withdraw a place which has been offered on the basis of incomplete orincorrect information./Signature of applicant (or guardian if under 18 years old)/DateI consent to BU providing information relating to the processing of my application to the agent whose details appear on thefront of this form and/or my nominated next of kin./Signature of applicant (or guardian if under 18 years old)Date/