Pathways application form
Tell us about yourself…
Your personal details
Family name
Given name(s)
Title
Date of birth (dd/mm/yyyy)
Gender
 Female
 Male
Age
 Indeterminate/Intersex/Unspecified
Residential address
Street address
Suburb/Town/City
State/Province
Country
Post/Zip code
Postal address (if different to residential address)
Street address
Suburb/Town/City
State/Province
Country
Post/Zip code
Home phone (incl. country code)
Mobile phone (incl. country code)
Email address
Previous ANU College ID
Previous ANU ID
Your parent/guardian/alternative contact person’s details
Family name
Title
Given name(s)
Date of birth (dd/mm/yyyy)
Relationship to you
Residential address
Street address
Suburb/Town/City
State/Province
Country
Post/Zip code
Home phone (incl. country code)
Mobile phone (incl. country code)
Email address
If you would like to authorise ANU to disclose details of your application to the parent/guardian/alternative contact
person listed above, or another person, please complete and attach to your application the form Consent to the
Disclosure of Personal Information available at www.anu.edu.au/files/resource/Consent-form.pdf
1 |
THE AUSTRALIAN NATIONAL UNIVERSITY & ANU COLLEGE
The Australian National University. CRICOS Provider Code: 00120C. ABN: 52 234 063 906
Study Group Australia Pty Limited trading as ANU College. CRICOS Provider Code: 01682E. ABN: 88 070 919 327
Your citizenship, passport, ATSI and visa details
As well as providing the details below, attach your passport.
Your citizenship
Your second citizenship
Your country of birth
Your passport number
Expiry date (mm/yyyy)
Are you a Permanent Resident of Australia?
 Yes
 No
Are you a holder of an Australian Humanitarian Visa?
 Yes
 No
Are you an Australian Aboriginal or Torres Strait Islander?
 Yes
 No
Do you currently hold, or have you had an Australian Visa in the past 6 months?
 Yes
 No
Visa type (if applicable)
Expiry date
Subclass
Do you have family members currently residing in Australia?
 Yes
 No
 Yes
 No
If yes, in which town/city do they reside?
Do you currently hold an OSHC policy?
Name of OSHC provider
Member number
Expiry date
Have you applied for an Australian visa?
Have you breached any visa conditions in any country?
 Yes
 Yes
 No
 No
Have you had a visa refused for Australia or any other country?
 Yes
 No
If yes, attach a copy of the formal visa refusal notification along with a statement from you regarding the
circumstances of the refusal.
Have you been convicted of any crime or offence in any country?
 Yes
 No
If yes, provide details including offence type and location:
Your English language proficiency
All students must demonstrate an acceptable level of English language proficiency to be admitted to ANU College
and ANU. Provide details of your most recent tests below and attach results from ALL tests undertaken in the last
two years.
Test name
Overall/Total
Test Date
(e.g. IELTS, TOEFL)
Listening
Speaking
Reading
Writing
Test name
Overall/Total
Test Date
(e.g. IELTS, TOEFL)
Listening
Speaking
Reading
Writing
Adjustment and inclusion
Do you have a disability, impairment or long-term medical condition which may affect your studies?
 No
 Acquired brain impairment
 Hearing
 Intellectual
 Learning
 Physical
 Medical condition
 Mental illness
 Mobility
 Vision
Funding
How do you intend to fund your studies?
 Self-funded
 Scholarship (provide scholarship name)
 Family-funded
 Sponsorship (provide sponsorship name)
2 |
THE AUSTRALIAN NATIONAL UNIVERSITY & ANU COLLEGE
The Australian National University. CRICOS Provider Code: 00120C. ABN: 52 234 063 906
Study Group Australia Pty Limited trading as ANU College. CRICOS Provider Code: 01682E. ABN: 88 070 919 327
Your previous education
Provide details of all secondary (e.g. high school) and tertiary (e.g. university or polytechnic) studies attempted.
You need provide documentation for all of your studies – see Documentation requirements below for details.
If you currently hold a conditional offer from ANU, attach a copy to this application.
Qualification level (e.g. senior secondary, postgraduate)
Qualification name
State/Country
Institution
Language(s) of instruction
Language(s) of assessment
Attended from (mm/yyyy)
Attended to (mm/yyyy or current)
Completed?
 Yes
 No
Did the qualification include a significant research component?
 Yes
 No
Completed?
 Yes
 No
Did the qualification include a significant research component?
 Yes
 No
Completed?
 Yes
 No
Did the qualification include a significant research component?
 Yes
 No
Have you ever been excluded, or are you facing exclusion, from study on academic
or other grounds?
 Yes
 No
If yes, length in words or months of study?
Qualification level (e.g. senior secondary, postgraduate)
Qualification name
State/Country
Institution
Language(s) of instruction
Language(s) of assessment
Attended from (mm/yyyy)
Attended to (mm/yyyy or current)
If yes, length in words or months of study?
Qualification level (e.g. senior secondary, postgraduate)
Qualification name
State/Country
Institution
Language(s) of instruction
Language(s) of assessment
Attended from (mm/yyyy)
Attended to (mm/yyyy or current)
If yes, length in words or months of study?
If yes, provide details including the date and duration of the exclusion:
3 |
THE AUSTRALIAN NATIONAL UNIVERSITY & ANU COLLEGE
The Australian National University. CRICOS Provider Code: 00120C. ABN: 52 234 063 906
Study Group Australia Pty Limited trading as ANU College. CRICOS Provider Code: 01682E. ABN: 88 070 919 327
Tell us about your pathway to ANU…
Your ANU degree program
Tell us which degree program you wish to study at ANU.
Find out about all degrees at programsandcourses.anu.edu.au. You may select only one degree. If you are not
eligible for your selected degree but you are eligible for another, we will contact you to discuss your options.
ANU degree (e.g. Bachelor of Arts):
Do you have professional experience related to your selected ANU degree?
 Yes
 No
If yes, provide brief details below and attach a copy of your résumé:
ANU College pathway programs
Pathway programs can be used to meet the admission requirements for your chosen degree that you have not yet
met. There are two types of pathway to ANU: English language-only and Academic + English language.
Academic + English language pathways lead into Bachelor Degrees only – they cannot be used to meet the
requirements for a Masters Degree, Graduate Certificate or Graduate Diploma.
We will determine the pathway that you need to meet the admission requirements of your chosen degree based on
your application - you are not required to work this out for yourself.
When can you start?
Select the month and year that you wish to commence your pathway to ANU.
We will determine the next available intake for your pathway from the date you select and no earlier than this date.
 January
 February
 March
 April
 May
 June
 July
 August
 September
 October
 November
 December
 2021
 2022
 2023
4 |
THE AUSTRALIAN NATIONAL UNIVERSITY & ANU COLLEGE
The Australian National University. CRICOS Provider Code: 00120C. ABN: 52 234 063 906
Study Group Australia Pty Limited trading as ANU College. CRICOS Provider Code: 01682E. ABN: 88 070 919 327
Applicant Declaration
To apply to ANU College and ANU, you must make the following declaration:
1.
I confirm that the documents presented as part of my application are a true and complete representation of my
study history. I understand that it is an offence to submit fraudulent documentation in support of an application
to The Australian National University (ANU) and/or Study Group Australia Pty Limited trading as ANU College
(ANU College).
2.
In the case that I have submitted incorrect, incomplete or fraudulent information, I understand that ANU and/or
ANU College will revoke my offer. If I am admitted or enrolled, I will be subject to relevant Statutes, Rules,
Orders, Codes, policies, procedures and guidelines of ANU and/or the policies, procedures and guidelines of
Study Group Australia and ANU College whereby, if I am found to have engaged in misconduct by providing
incorrect, incomplete or fraudulent information, ANU and/or ANU College may vary or cancel my enrolment and
any ANU scholarship(s), as prescribed. This may result in my application being denied and/or cancelled, and
any enrolment terminated, and I may be referred to government and statutory authorities.
3.
I understand that in some cases ANU and ANU College make decisions based on the information provided by
relevant third parties such as referees, sponsors, external scholarship providers, registered partners, and on
advice received from other relevant institutions. I understand that ANU and ANU College have the right to vary
or cancel an application or enrolment (including any scholarship(s)) if ANU or ANU College subsequently find
that such information or advice is incorrect or untrue or misleading or fraudulent.
4.
I acknowledge and agree to provide original documents if requested by ANU and/or ANU College.
5.
I acknowledge and agree that all documents provided for my admission become the property of ANU and ANU
College and will not be returned except at the discretion of ANU and/or ANU College.
6.
I acknowledge and agree to ANU and/or ANU College auditing information presented for my admission,
including but not limited to qualifications, English language proficiency and referee reports, and that this
includes obtaining official records from institutions or issuing bodies for the purpose of verification of my
supporting documents.
7.
I acknowledge and agree to ANU and/or ANU College providing my personal information to any relevant third
party for auditing and verification purposes, consistent with the ANU Privacy Policy or ANU College SGA
Student Privacy Policy, as applicable.
8.
I declare that I am a Genuine Student and Genuine Temporary Entrant and that I have read and understood the
conditions in relation to these requirements as defined on the Genuine Temporary Entrant requirement page on
the Australian Government website. I understand that if ANU and/or ANU College form the opinion that I am not
a Genuine Temporary Entrant or a Genuine Student or I do not meet the Genuine Temporary Entrant and
Genuine Student requirements set by Department of Home Affairs and/or I am unable to obtain or maintain a
student visa, ANU and/or ANU College may: refuse to assess my application; withdraw an offer of admission
and/or; cancel my enrolment.
9.
I authorise ANU and ANU College to check my visa and residency status using the Australian Government’s
Visa Entitlement Verification Online (VEVO) tool.
10. I understand that if my application is made in relation to, or subsequently becomes related to, an ANUapproved external scholarship/sponsorship provider or an ANU Strategic Partnership, my acceptance to ANU
may be conditional on being awarded the scholarship/sponsorship or conditions specified under the terms of
the ANU Strategic Partnership agreement.
11. I understand that ANU and ANU College are bound by the Privacy Act 1988 of the Commonwealth of Australia,
and that ANU and ANU College collect and use any personal information provided in accordance with the Act.
Your name
Your signature
Date:
If you are under 18 years of age, this declaration must also be signed on your behalf by a parent/guardian or a
person/authority who has legal responsibility for you.
Parent/guardian’s name
Parent/guardian’s signature
5 |
Date:
THE AUSTRALIAN NATIONAL UNIVERSITY & ANU COLLEGE
The Australian National University. CRICOS Provider Code: 00120C. ABN: 52 234 063 906
Study Group Australia Pty Limited trading as ANU College. CRICOS Provider Code: 01682E. ABN: 88 070 919 327
Applicant Declaration (continued)
12. I authorise ANU and ANU College to share and exchange personal and academic information about me for the
duration of my enrolment in any program administered by either entity, and later as an alumni of ANU if
applicable.
13. I understand that if I am a sponsored student, the personal information collected by ANU and ANU College,
including academic progress, results, attendance or financial standing, may be disclosed to my sponsor, my
embassy, cultural mission or any third party appointed by my sponsor, my embassy and/or cultural mission.
14. I understand that ANU and ANU College are required under Section 19 of the ESOS Act 2000, to inform the
Department of Home Affairs about changes to my enrolment and any breach of my student visa conditions
relating to satisfactory academic performance. I also understand that under the provisions of the ESOS Act
2000, ANU and ANU College may release information provided in this application to Australian Commonwealth
and State agencies, including the Tuition Protection Service.
15. I authorise ANU and ANU College to collect, receive, store, transfer and use all such information; and all
information in or connected with this application for training and/or research purposes. I give these authorities
on the condition that all information provided pursuant to training and/or research purposes is de-identified.
16. I understand that the type of information and the use and disclosure of that information by ANU College without
any prior approval is set out in the SGA Student Privacy Policy, which can be found
at https://anucollege.edu.au.
17. I have read the SGA Student Privacy Policy and consent to the use and disclosure of my personal information
as set out in the Policy.
18. I understand that ANU collects, retains, uses and discloses personal information about me to enable ANU to
meet its operational requirements to me and its legal obligations, as detailed in the ANU Privacy
Policy: https://policies.anu.edu.au/ppl/document/ANUP_010007
19. I have read the ANU Privacy Policy and consent to the collection, retention, use and disclosure of my personal
information as set out in the Policy.
I do not wish to receive related useful features, products and promotional offers from Study Group and
affiliates via email, SMS and post.
Your name
Date:
Your signature
If you are under 18 years of age, this declaration must also be signed on your behalf by a parent/guardian or a
person/authority who has legal responsibility for you.
Parent/guardian’s name
Parent/guardian’s signature
Date:
Agent details
Agency
Branch
Agent ID
Email
Name
Signature
Office use only
Custodian
 ANU (Direct / ANU agent)
 SGA (SGA agent)
Eligibility Cohort
 Global Diversity
 Other
 Partnership
 Sponsorship
6 |
THE AUSTRALIAN NATIONAL UNIVERSITY & ANU COLLEGE
The Australian National University. CRICOS Provider Code: 00120C. ABN: 52 234 063 906
Study Group Australia Pty Limited trading as ANU College. CRICOS Provider Code: 01682E. ABN: 88 070 919 327
Documentation requirements
Evidence of previous education
• For each academic qualification you have attempted, you need to provide an academic transcript. You should
also provide the institution’s grading system, if available.
• For each academic qualification you have completed, you need to provide an academic transcript and a
completion/graduation/degree certificate or testamur. If you were issued a degree certificate and a graduation
certificate, provide both. You should also provide the institution’s grading system, if available.
• If you hold a conditional offer from ANU, provide a copy with your application.
Evidence of English language proficiency
• For English language test results, you need to provide an official test report certificate. Usually, this will include
a photo of you. A summary/confirmation email containing your scores will not be sufficient as evidence.
• For previous studies taught and assessed in English, you need to provide a formal statement from the
institution, duly signed, and specifying your name, the name of the qualification and a statement confirming that
the qualification was both taught and assessed entirely in English.
Translation into English
If an original document is in a language other than in English, you need to provide an English translation along with
the original. The translation must be provided by:
• a translator accredited by National Accreditation Authority for Translators & Interpreters (NAATI);
• the Community Relations Commission for Multicultural New South Wales;
• the Interstate office of either the Ethnic Affairs Commission or the Department of Home Affairs;
• an Australian diplomatic mission or;
• a national government or other nationally-recognised translation authority.
Document format
Documents can be scanned and attached to this application (electronically or hardcopy) in their full original colour.
Photographs cannot be accepted. Documents may be sent by your institution to pathways@anu.edu.au
Submission checklist
 All sections of the application form have been completed
 Your personal details and parent/guardian/alternative contact person’s details
 Your citizenship, passport, ATSI and visa details
 Your English language proficiency
 Adjustment and inclusion
 Funding
 Your previous education
 Your selected Pathway program and ANU degree program
 Attached passport
 Attached previous visa refusal and statement of circumstances (if applicable)
 Attached evidence of English language proficiency is attached
 Attached colour copies of academic transcripts and graduation certificates/testamurs for all previous qualifications
 Attached English translations of non-English academic transcripts and graduation certificates/testamurs
 Attached a copy of your résumé, if required
 Application Declaration signed by you (and your parent/guardian if you are under 18 years old)
Submitting your application
Simply send a complete, signed copy of your application and all attachments by email to pathways@anu.edu.au
7 |
THE AUSTRALIAN NATIONAL UNIVERSITY & ANU COLLEGE
The Australian National University. CRICOS Provider Code: 00120C. ABN: 52 234 063 906
Study Group Australia Pty Limited trading as ANU College. CRICOS Provider Code: 01682E. ABN: 88 070 919 327