APPLICATION FORM

1Have you previously applied for a place or been enrolled in a program at RMIT?

Yes Student ID

Gender

Male Female Other

Personal information

2 Contact information

Permanent home address As permanent home address

Personal contact details

Home phone

Mobile

Email

House number and street name

Ward

District or townProvince or city

In case of emergency, please specify which hospital should be chosen (tick ONE box only)Hospital designated by campus medical clinic

Student preference (please indicate hospital)

3 Academic records

Have you previously been expelled from RMIT Vietnam or any other college or university? (leave blank if not applicable)

Yes College or university

Postal adressHouse number and street name

Ward

District or townProvince or city

Company

Occupation

In an emergencyFamily contact details

Mobile

Relationship

Email

I agree for RMIT to contact the below nominee:

Contact’s full name

Release of study progress

Occupation

Other college or university

Study locationProgram name

CompletedProgram level

Duration from (mm/yyyy) to (mm/yyyy)

Reason

Other college or university

Study locationProgram name

CompletedProgram level

Duration from (mm/yyyy) to (mm/yyyy)

College or university

Study locationProgram name

CompletedProgram level

Duration from (mm/yyyy) to (mm/yyyy)

Please fill in your family name, middle name(s) and given name as stated in your ID card/passport

Family name

Middle name(s)

Given name

Date of birth (dd/mm/yyyy)

NationalityVietnamese - Ethnic Other (please specify)

Application ID

5 Registration for postgraduate programProgram

Master of Business AdministrationMaster of International BusinessMaster of Global Trade

CampusSaigon SouthHanoi City

SemesterFeb 20Jun 20Oct 20

6 Special offer

Family discount (5%)*Family member’s student ID

Alumni discount (10%) for RMIT Vietnam or any Australian universities Program completedCampus

Fixed fee (applicant will have to submit a seperate form)

7 Equitable Learning serviceRMIT Vietnam is committed to providing an accessible and supportive learning environment for all students. If you have special requirements, please indicate the type of support you need below:

Hearing Mobility Learning

Vision

Medical

Other (please specify)

8 Applicant declarationPlease read and sign the following declaration. This application is not valid unless signed and dated.

I declare that, to the best of my knowledge, the information supplied in this application and supporting documentation is correct and complete. I will notify RMIT Vietnam immediately of any change to my personal details.I acknowledge that the provision of incorrect information or the withholding of information or documentation relating to my application may result in the cancellation of any offer or enrolment by the University.I understand that the release form allows information, including my personal details and information about my academic and financial records, to be released.

This permission is granted provided the University releases information only for the reason(s) nominated and only after proper identification has been made.I understand that RMIT Vietnam may be required to release information about my status as a student to other bodies as part of its legal requirements within Vietnam and Australia.I understand that RMIT Vietnam reserves the right to discontinue or alter any program, course/subject, fee, admission requirement, staffing or other arrangement without prior notice.

Applicant’s signature

Full name

Date (dd/mm/yyyy)

PA’s stamp and signature

FOR OFFICE USE ONLY (Applicant does not fill in this section)

Received by PA on

Admissions’ stamp and signature

Received by Admissions on

Selection officer’s stamp and signature

Received by selection officer on

Selection officer’s Approval

Unconditional Conditional on EnglishOther

Your most recent English language certificateTest date Result

Register for English for University IELTS Test PreparationCommencement dateLevel

4 Registration for English program (for non-native English speakers)

*Applicant must provide notarised copy of birth certificate/marriage certificate.

(*) Privacy statementRMIT University collects and uses your personal information to enable pre-selection, enrolment and provision of educational services. Your personal information will be held securelyby the University and can be accessed by you on request. The University may be required to disclose information in certain circumstances, for example to the Australian governmentagencies, including the Department of Education and Training. For more information please refer to the RMIT University's privacy statement at https://www.rmit.edu.au/utilities/privacyor contact privacy@rmit.edu.au.

I have read and understood RMIT University's privacy statement and accept its conditions (*).