Registration Form

INTERNATIONAL
EDUCATION AGENT STAMP

APPLICATION FORM
THIS FORM IS FOR INTERNATIONAL
STUDENTS ONLY
This application will not be processed unless all information has been provided.
PLEASE PRINT CLEARLY.
It is recommended you submit your application a minimum of 12 weeks before your
intended semester or trimester start date. Late applications may be considered for next
available intake.
Please check if your program has a specific closing date at newcastle.edu.au/degrees
If you choose to apply through an education agent, you should ensure that your agent is contracted to the University
of Newcastle to avoid delays with your application. For a list of contracted education agents in your country
visit: newcastle.edu.au/international/uon-in-your-country/education-agents
If this Application Form is being lodged by an education agent, please make sure the UON Agent ID is included on the
application form where indicated.
UON Agent ID
Have you previously applied to the University of Newcastle?
No X Yes If yes, please provide Student ID Number
I am applying for: Undergraduate study X Postgraduate study
SECTION ONE – PERSONAL DATA

1. Personal details
Title (Dr, Mr, Miss, Mrs, Ms) MS

First/Given Name MARWA
Other Name(s)
Family Name LMABROUK
Previous Family Name

Date of Birth D16/03/2003
D/MM/YYYY Female X Male Other, please specify
2. Contact details
Street Address MOULAY RACHID HAYSADRY GR5 RUE58 NO92 CASA
Suburb/Town/City
CASABLANCA State
Country
MAROCCO Postal/Zip 20670
Phone ( 212)
630046779 Mobile ( 212) 661426730
Email [email protected]
3. Citizenship and Visa details

Country of Birth maroccco
Country of Citizenship maroccain
Do you hold a current student visa? No x Yes Visa Type Expiry Date D D / M M / Y Y Y Y
Have you had a previous visa refusal? No x Yes
If yes, please provide a statement of purpose explaining how your circumstances have changed.
Do you have family living in Australia? No x Yes If yes, where in Australia?
2018 1006 | CRICOS Provider 00109J

It is a condition of your student visa to have Overseas Student Health Cover (OSHC) for the duration of your visa.
The University of Newcastle’s preferred provider is Allianz Global Assistance (www.oshcallianzassistance.com.au).
If you are applying for a student visa and would like the University to arrange your OSHC (Essentials Cover) on your
behalf, please indicate the OSHC policy you require:
Single Dual Family Multi Family Not required
Single Covers only the valid student visa holder.

Dual Family Covers one valid student visa holder plus either one adult spouse or recognised de-facto partner
or one or more dependant children.
Multi Family Covers one valid student visa holder plus more than one dependant which can only include one adult
spouse or recognised de-facto and one or more dependant children.
4. Program Preferences
First preference degree name business management
Major business management
Campus Newcastle (Callaghan and/or City) Central Coast Sydney
Intake Semester 1 (February) Semester 2 (July)
Trimester 1 (February) Trimester 2 (May) Trimester 3 (September) Year 2022
Second preference degree name ECONOMIC
Major ECONOMIC
Campus Newcastle (Callaghan and/or City) Central Coast Sydney
Intake Semester 1 (February) Semester 2 (July)
Trimester 1 (February) Trimester 2 (May) Trimester 3 (September) Year 2022
Pathway to Undergraduate Programs

Please note that if your application does not meet the minimum admission requirements for direct entry to the University
of Newcastle, it may be possible for you to be admitted to an academic program at the Newcastle International College
(NIC), a pathway college associate with the University of Newcastle. We will refer your application on to NIC if this is the case.
Successful completion of your studies at the Newcastle International College is an alternate pathway to particular University
of Newcastle bachelor degrees. For more information please visit: nic.nsw.edu.au
5. Credit
To be considered for credit or advanced standing you need to supply the program outline, subject outlines, method(s) of
assessment, contact hours, duration of the program, and a full list of the text books used. All program course and subject
information should be from official educational institution publications and handouts. To be assessed for credit you must
provide your intended major.
Do you wish to apply for credit or advanced standing? Yes No
SECTION TWO – RELATED EXPERIENCE

6. Education
Please attach copies in full colour and official translations of academic transcripts and completion certificates.
Are you currently enrolled in a qualification? No Yes
If yes, what qualification, when are you scheduled to complete, and do you intend to complete.
I GOT MY BACCALAUREAT IN 2021,AND I WANT TO STUDY A BACHELOR'S DEGREE
7. Employment history (attach a more detailed statement if applicable) for specific postgraduate applications only.
Please submit a CV/resume and certified copies of your work references. Your work references should have an official letter
head, your employer's contact information, what duties and responsibilities you had, and the duration of your employment.

8. English proficiency
Have you completed any of the following language tests in the last two years?
IELTS iTOEFL PTE Other If other, what

Please attach evidence of your English language proficiency. If you do not meet the English proficiency requirements,
you may be required to undertake ELICOS at the University of Newcastle Language Centre. Students may choose to
undertake ELICOS in lieu of a test report and will be offered a minimum of 30 weeks of ELICOS study. If requesting
ELICOS please indicate the number of weeks you wish to study. The English Proficiency Policy is located at:
newcastle.edu.au/about-uon/governance-and-leadership/policy-library/document-record?RecordNumber=D15/15438
9. Disabilities
The information provided below will assist the University in monitoring and improving services to assist students with
special needs.
Do you have a disability or long-term medical condition which may affect your studies? No Yes
If yes, please indicate the type of disability that applies:
Hearing Vision Learning Medical Mobility Other
Do you require Support Services? No Yes
If yes, please indicate the type of support services you require
SECTION THREE – DECLARATION

The University of Newcastle Privacy Policy
The information you provide will be used by the University of Newcastle for the primary purpose of assessing your
application for admission to a program of study at the University of Newcastle. If you choose not to provide all the
information on this document, it may not be possible for the University to process your application.
Personal information collected may be disclosed to local or overseas third party organisations who are engaged by the
University to assist with enquiry management, data management, pre-screening and other assessments related to your
eligibility for admission and processing of applications. This may include, but is not limited to your: name, address, student
identification, phone number, date of birth, email address, citizenship and visa details, academic transcripts, employment
history, disability information and financial information. Other purposes of this information include updating your enrolment
record on the student database, corresponding with you, informing you about your program of study, statistical analysis and
reporting and complying with legislative reporting requirements. It may also be disclosed to government agencies (e.g. the
Department of Home Affairs) as required by legislation or pursuant to obligations under the Education Services for Overseas
Students (ESOS) Legislative Framework or for your visa application.
Information may be shared with the registered agent you appoint to assist with your application for admission or visa
processing. Your personal information may also be released in the event of an accident or an emergency. The University
will not otherwise disclose your personal information without your consent unless the University is under a legal obligation
to do so. You have the right to access personal information that the University of Newcastle holds about you, subject
to legislation. If you wish to seek access to your personal information or enquire about the handling of your personal
information, contact the University of Newcastle’s Privacy Officer at [email protected]. Due to privacy regulations we
will not disclose personal information to any other third parties such as friends, relatives and parents without your consent,
except in certain emergency situations. All documents provided to the University of Newcastle will be retained in accordance
with the NSW State Records Act 1998.
Further information on Privacy at University of Newcastle can be located in the Privacy and Information Access Policy and
the PrivacyManagement Plan on the University's website.
10. Contracted Agent Representative Declaration

As part of the application process, all contracted agent representatives of the University of Newcastle are required to sight
the prospective student’s original documents as part of their student counselling process.
I have sighted all supporting documents submitted with this application, and declare that they are true copies of the
original documents.
Signature of Agent Counsellor Date DD/MM/YYYY
Name of Agent Counsellor Date DD/MM/YYYY
Position and Agency Date DD/MM/YYYY

11. Declaration
I declare that the information I have supplied in this application is correct and complete.
I understand that it is an offence to submit fraudulent documentation in support of an application for the purpose of
gaining admission to the University of Newcastle.
I understand that the University of Newcastle may vary or cancel any decision it makes if the information I have supplied is
found to be incorrect or incomplete.
68
I understand that all documents submitted with this application will be retained by the University of Newcastle in
accordance with the Legislation.
I hereby authorise the University of Newcastle to obtain further information with respect to my application if necessary.
I declare that I am a Genuine Temporary Entrant (GTE) and a Genuine Student and that I have read and understood the
conditions in relation to these requirements: www.immi.gov.au/students/gte-requirement.htm
I declare that I will comply with the rules of the University of Newcastle governing admission and enrolment.
If you are under the age of 18 your parent/legal guardian will need to sign the below:
Signature MARWA LMABROUK Date D24/12/2021

D/MM/YYYY
Parent's Signature ABDRAHIM LMABROUK Date D D24/12/2021

/MM/YYYY
Send your completed application form:
Email:
[email protected]
Postal address:
International Admissions Management
The University of Newcastle
University Drive
Callaghan NSW 2308
AUSTRALIA

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INTERNATIONAL

EDUCATION AGENT STAMP

SECTION ONE – PERSONAL DATA

Title (Dr, Mr, Miss, Mrs, Ms) MS

Previous Family Name

3. Citizenship and Visa details

Country of Citizenship maroccain

Do you have family living in Australia? No x Yes If yes, where in Australia?

2018 1006 | CRICOS Provider 00109J

Single Covers only the valid student visa holder.

First preference degree name business management

Major business management

Campus Newcastle (Callaghan and/or City) Central Coast Sydney

Intake Semester 1 (February) Semester 2 (July)

Trimester 1 (February) Trimester 2 (May) Trimester 3 (September) Year 2022

Second preference degree name ECONOMIC

Campus Newcastle (Callaghan and/or City) Central Coast Sydney

Intake Semester 1 (February) Semester 2 (July)

Trimester 1 (February) Trimester 2 (May) Trimester 3 (September) Year 2022

Pathway to Undergraduate Programs

SECTION TWO – RELATED EXPERIENCE

2018 1006 | CRICOS Provider 00109J

IELTS iTOEFL PTE Other If other, what

Hearing Vision Learning Medical Mobility Other

Do you require Support Services? No Yes

If yes, please indicate the type of support services you require

SECTION THREE – DECLARATION

10. Contracted Agent Representative Declaration

Name of Agent Counsellor Date DD/MM/YYYY

Position and Agency Date DD/MM/YYYY

2018 1006 | CRICOS Provider 00109J

Signature MARWA LMABROUK Date D24/12/2021

Parent's Signature ABDRAHIM LMABROUK Date D D24/12/2021

Send your completed application form:

2018 1006 | CRICOS Provider 00109J

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