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Australian Medical Review Centre Level 1, 7-9 Churchill Avenue, Strathfield NSW 2135 P: + 61 2courses@amrc.net.au | Website: www.amrc.net.au ABN: 49 159 636 049 APPLICATION FORM for MCQ BRIDGING COURSE Course Details Duration: 5 weeks Fee: AUD$3,300 Application closes 2 weeks before course commencement or when course is full, whichever is earlier. How to Apply * To apply, complete the following documents and send as email attachment to courses@amrc.net.au . 1. Scanned copy of your passport photo page 2. Your CV 3. Proof from AMC stating that you have been assessed as eligible to sit the AMC CAT exam, e.g. a screenshot from the AMC portal 4. Proof of your payment receipt, e.g. screenshot of bank transfer receipt MCQ Bridging Course 2017-2018 intake dates. Select the intake you are applying for: * Payment Methods *  Bank transfer Bank Westpac Banking Corporation Branch Haymarket, Sydney Account name Australian Medical Review Centre Pty Ltd BSB 032 028 Account no. 376 081 Swift code WPACAU2s Reference Applicant name  Credit card (AMEX not accepted) Each transaction made with credit card will incur a 2.4% surcharge. Card type Card no. ☐ Visa ☐ Mastercard Card holder name Expiry date (mm/yy) CCV Amount (in AUD)  28 Aug – 29 Sep, 2017  25 Jun – 27 Jul, 2018  6 Nov – 8 Dec, 2017  3 Sep – 5 Oct, 2018  10 Jan – 9 Feb, 2018   5 Nov – 7 Dec, 2018 I agree to pay the 2.4% surcharge on top of the amount stated  9 Apr – 11 May, 2018 above. (This box needs to be checked for the credit card payment to be processed.) Applicant Details * Terms & Condition * • Booking fee of AUD$1,000 is required with application to secure a spot. The booking fee is non-refundable. Surname • The fee is non-transferable to another person. • Full payment must be completed for the issuance of a Confirmation Date of Birth (dd/mm/yyyy) Letter. Payment and confirmation process may require 5-10 business days. • Withdrawal from the course anytime 2 weeks prior to the course will Country of Origin incur a cancellation fee of AUD$1,000. • Any cancellation/withdrawal in the 2 weeks leading to the course Address • commencement will not qualify for any refund. If candidate is unable to attend due to visa refusal, proof of evidence need to be given and a processing fee of AUD$200 will be deducted from the refund amount. Contact no. • Your personal information is used only for purposes directly related to the reason you provided it for, with the exceptions under the Privacy Email Act. Terms of Service * AMC Candidate no. ☐ I agree to the terms of service. When do you plan Signature * to sit the AMC BY SIGNING I CERTIFY THE INFORMATION ABOVE IS TRUE AND CORRECT exam? (mm/yyyy) TO THE BEST OF MY KNOWLEDGE. Sign here Date: Official Use Only ☐ All application documents are completed and received Comment Signature Date " id="pdf-obj-0-2" src="pdf-obj-0-2.jpg">

Australian Medical Review Centre

Level 1, 7-9 Churchill Avenue, Strathfield NSW 2135 P: + 61 2 9007 4235 | M: +61 450 458 086 E: courses@amrc.net.au | Website: www.amrc.net.au ABN: 49 159 636 049

APPLICATION FORM for MCQ BRIDGING COURSE

Course Details
Course Details

Duration: 5 weeks Fee: AUD$3,300

Application closes 2 weeks before course commencement or when course is full, whichever is earlier.

How to Apply *
How to Apply *

To apply, complete the following documents and send as email attachment to courses@amrc.net.au.

  • 1. Scanned copy of your passport photo page

  • 2. Your CV

  • 3. Proof from AMC stating that you have been assessed as eligible to sit the AMC CAT exam, e.g. a screenshot from the AMC portal

  • 4. Proof of your payment receipt, e.g. screenshot of bank transfer receipt

MCQ Bridging Course 2017-2018 intake dates. Select the intake you are applying for: *

Payment Methods *

  • Bank transfer

Bank

Westpac Banking Corporation

Branch

Haymarket, Sydney

Account name

Australian Medical Review Centre Pty Ltd

BSB

032 028

Account no.

376 081

Swift code

WPACAU2s

 

Reference

Applicant name

  • Credit card (AMEX not accepted)

Each transaction made with credit card will incur a 2.4% surcharge.

Card type

Card no.

Visa

Mastercard

Card holder name

Expiry date

(mm/yy)

CCV

Amount (in AUD)

  • 28 Aug 29 Sep, 2017

  • 25 Jun 27 Jul, 2018

  • 6 Nov 8 Dec, 2017

  • 3 Sep 5 Oct, 2018

 
  • 10 Jan 9 Feb, 2018

5 Nov 7 Dec, 2018

I agree to pay the 2.4% surcharge on top of the amount stated

  • 9 Apr 11 May, 2018

above. (This box needs to be checked for the credit card payment to be processed.)

Applicant Details *

Terms & Condition *

Given name

Booking fee of AUD$1,000 is required with application to secure a

 

spot. The booking fee is non-refundable.

Surname

The fee is non-transferable to another person.

Full payment must be completed for the issuance of a Confirmation

Date of Birth (dd/mm/yyyy)

 

Letter. Payment and confirmation process may require 5-10 business days.

 

Withdrawal from the course anytime 2 weeks prior to the course will

Country of Origin

incur a cancellation fee of AUD$1,000.

 

Any cancellation/withdrawal in the 2 weeks leading to the course

Address

commencement will not qualify for any refund. If candidate is unable to attend due to visa refusal, proof of evidence need to be given and a processing fee of AUD$200 will be deducted

from the refund amount.

Contact no.

Your personal information is used only for purposes directly related to

 

the reason you provided it for, with the exceptions under the Privacy

Email

Act.

Terms of Service *

AMC Candidate no.

I agree to the terms of service.

When do you plan

Signature *

to sit the AMC

BY SIGNING I CERTIFY THE INFORMATION ABOVE IS TRUE AND CORRECT

exam? (mm/yyyy)

TO THE BEST OF MY KNOWLEDGE.

Sign here

Date:

Official Use Only

All application documents are completed and received

 

Comment

Signature

Date