ANU EXCHANGE

Application form for travel in 2021/22

To be returned with full supporting documentation by Monday 1 February 2021 to studyabroad@admin.ox.ac.uk.

Please note that incomplete or late applications will not be accepted. Please note that this form is only for current
students enrolled at Oxford wishing to complete a period of study or research in Australia.

Section A – PERSONAL INFORMATION

Title ☐ Mr ☐ Mrs ☐ Miss ☐ Ms ☐ Mx ☐ Other (please specify)      
First name(s)       Preferred name      
Surname / Family name      
Date of birth      
University email address      
Correspondence address Permanent address (if different)
           

Country of citizenship Country of residency

(Please confirm your country of ordinary residency prior
to commencing your current degree at Oxford.)
           

Section B – COURSE DETAILS

Student number       College      
Department or Faculty      
Degree (e.g. DPhil)       Subject (e.g. English)      
Start date of programme       Expected completion date      
Project or thesis title      

Section C – DETAILS OF PROPOSED STUDY ABROAD

Start date of study       End date of study      
Have you already contacted ANU about your proposed study period? ☐ Yes ☐ No
ANU EXCHANGE
Application form for travel in 2021/22
If yes, please give the name and position of the person you have contacted and provide details of the outcome of
this contact:      

Section D – AWARD AND FINANCIAL INFORMATION

Have you applied for or secured any other funding for your travel / study abroad? ☐ Yes ☐ No
If you have applied for or secured any other funding for your travel / study abroad, please confirm the amount,
funding organisation and current status of your application.
Funding organisation Amount Current status
      £      ☐ Pending ☐ Confirmed
      £      ☐ Pending ☐ Confirmed
      £      ☐ Pending ☐ Confirmed
      £      ☐ Pending ☐ Confirmed

Section E – REFEREES
Please provide two academic letters of reference to support your application. You may obtain the letters of
reference from your referees and attach them to your application, or these can be sent directly to
studyabroad@admin.ox.ac.uk. Please note Student Fees and Funding will NOT request references on your behalf.
In case of queries, please give the name and contact details of your academic referees below.
Referee 1
Title ☐ Prof. ☐ Dr ☐ Mr ☐ Ms ☐ Other (please specify)      
First name      
Surname      
Position      
Email address      
Referee 2
Title ☐ Prof. ☐ Dr ☐ Mr ☐ Ms ☐ Other (please specify)      
First name      
Surname      
Position      
Email address      
ANU EXCHANGE
Application form for travel in 2021/22

Section F – SUPPORTING STATEMENT

Please state your reasons for wishing to study at ANU, provide an outline of the courses or research you would
undertake, and state how this will benefit your studies at Oxford (max 500 words).
Please note that this is not intended to be a detailed outline of your research interests and should be written in
language which can be understood by a non-specialist.
     

STUDENT DECLARATION
I declare that the information I have given on all parts of this application form is correct and complete to the best
of my knowledge, and if information is knowingly incorrect my award could be revoked. I confirm that I have
sought approval from my tutor or supervisor to undertake this period of study abroad.

Name:       Signature:       Date:      

ANU EXCHANGE
Application form for travel in 2021/22
APPLICATION CHECKLIST

Please ensure you submit the following documentation:

All students:

☐ Completed application form

☐ CV
☐ Two academic letters of reference to support your application. You may obtain the letters of reference from
your referees and attach them to your application, or these can be sent directly to
studyabroad@admin.ox.ac.uk.
Please note Student Fees and Funding will NOT request references on your behalf.
☐ Applicants are required to submit a letter of support from their college, whereby the college agrees in principle
to host an incoming ANU exchange student. Please note that this does not have to be a guarantee of
accommodation.

Please note you should not submit your application until you are able to include all of the required supporting
documentation. If you have any questions about the scheme, please email studyabroad@admin.ox.ac.uk or visit
http://www.ox.ac.uk/students/fees-funding/international/scholarships-exchanges

Please send your application and supporting documentation to studyabroad@admin.ox.ac.uk.

Deadline:
Complete applications must be received by Student Fees and Funding at the above email address no later than 12
noon on Monday 1 February 2021. Late or incomplete applications will not be accepted under any circumstances.