AUG Student Services - Application Form

for Australia Institutions

Personal Details :
Title: Mr. / Ms. (Please circle)
Family Name: _____________________________ First Name: _____________________________________________

Date of Birth: ________ / _________ / __________ Passport No: ____________________________________________

Home Address: ______________________________________________________________________________________

dd mm yyyy
___________________________________________________________________________________________________

Tel No: ( ) ___________________________ Fax No: ( ) _______________________________________

Mobile No: ( ) _________________________ Email: __________________________________________________

Institutions
Country and Courses Interested Citizenship:
of Birth: ___________________________ (in order______________________________________
of preference) :
Application Submission
Institution Course Name Intake
Date (Office Use Only)
Language Spoken at home: ____________________________________________________________________

1.

2.

3.

Education Background (Previous & Current) :

From To

Name of School Course mm yy mm yy

Student Declaration and Signature :

I, hereby nominate and authorized AUG to submit my institutions application and handle all correspondences pertaining to my
offers and other application/acceptance matters.
I have provided true and correct personal information for the purpose of this application. I will inform AUG of any changes in the
course preferences and other information provided above. I agree that AUG will not be held responsible for submission of
incorrect information which, may be provided.
Misleading information is a serious offence under the Criminal Code of the Commonwealth Government of Australia.
I comply with the rules on admissions and enrolment with the universities I will be applying.

Signature: _______________________________ Date: _________________________

8, Jalan SS 15/8, 47500 Subang Jaya, Selangor, Malaysia.

Tel: + 60 3 5634 3767 Fax: + 60 3 5633 3652 | Email: malaysia@augstudy.com | www.augstudy.com
For Student Under 18 Years Old:
Parent’s/ Legal Guardian’s Name: _____________________________________________

Relationship: _____________________________________________

Home Address: _________________________________________________________________________________

_______________________________________________________________________________________________

Mobile No: ( ) _________________________ Email: _____________________________________________

Parent’s Signature: ___________________________ Date: ______________________________________

Language Spoken at home: ____________________________________________________________________

Checklist

 Academic Transcripts from Year 11 (SPM/ IGCSE) or equivalent to highest qualification

 Completion Letter/ Certificate

 Proof of English Proficiency (Letter of Medium of Instruction/ IELTS Academic/ PTE Academic or
equivalent)

 Detailed Course Syllabus

 Resume/ Statement of Activities/ Personal Statement

 Passport

8, Jalan SS 15/8, 47500 Subang Jaya, Selangor, Malaysia.

Tel: + 60 3 5634 3767 Fax: + 60 3 5633 3652 | Email: malaysia@augstudy.com | www.augstudy.com
 Student and Agent Agreement
I (the Student), would like to appoint AusEd UniEd International Pty Ltd / Unied Smart Study Centre Sdn Bhd
(trading as AUG, also known as the Agent) as my authorized representative to handle all my application
processing, correspondences and enrolment with institution/s as well as assistance and guidance with my
student visa application. AUG will assist me in getting an offer of place from academic institution/s;
enrolment and tuition fee payment procedures; student visa application; acquiring insurance coverage;
accommodation arrangement; and airport pick-up, if required.

AUG has given me information about the following and I acknowledge that the below is not an exhaustive list
of AUG advise and may include other information deemed necessary to my application:
• Accurate, detailed and up-to-date institution/s’ course information, program entry requirements,
institution location and available facilities, international student support and learning resources, and
program acceptance requirements.
• Course fee details and institution refund policies, indicative cost of living, and accommodation
options.
• International Student insurance coverage and corresponding fees.
• Detailed student visa requirements and process.
• Information about the grounds on which the Student's enrolment may be deferred, suspended or
cancelled.

AUG has advised that:

• If my student visa application is refused, the academic institution will refund my prepaid fees in
accordance to the academic institution’s refund policy of which I have been given and fully informed
about prior to my acceptance and payment of tuition fees.
• On a Student Visa, my primary purpose is to study to gain an academic qualification and I must
undertake full-time study in a recognized academic institution.

I understand that:
• Should any of my documents be found fraudulent, I would be held accountable for all consequences
and liabilities.
• The respective Immigration Office/Embassy may refuse or cancel my student visa if I provide
misleading information and fraudulent documents; am not a genuine and bona fide student (genuine
temporary entrant); or do not meet health and character requirements.
• I will abide and adhere to the visa conditions as stated in my student visa grant.
• Should I breach any of the visa conditions, the respective Immigration Office/Embassy may cancel
my student visa and may result to consequences as stipulated in their visa policies.
• AUG’s role in the visa assistance does not mean we have connections with the visa officers of any
country and guarantee visa approval.

AUG does not charge a service fee for my application/s. The fees I will pay will be directly remitted to the
academic institution (if applicable) and/or to the Immigration Office/Embassy for my student visa application.
As an International Student, I have read and understood the below information that is relevant to my
application:
• AUG Privacy Policy: https://augstudy.com/terms-and-conditions/
ESOS Legislative Framework (For students bound for Australia)
https://internationaleducation.gov.au/Regulatory-Information/Pages/Regulatoryinformation.aspx
• ESOS Act: https://www.legislation.gov.au/Details/C2018C00210
• The National Code of Practice for Providers of Education and Training to Overseas Students 2018
(National Code 2018) https://internationaleducation.gov.au/Regulatory-
Information/Pages/National-Code-2018-Factsheets-.aspx and
https://www.legislation.gov.au/Details/F2017L01182
• Singapore: Advisory Note and Student Contract (For students bound for Singapore)
https://www.ssg.gov.sg/cpe/student-services/student-resources/student-advisories/read-your-
advisory-note-and-student-contract.html

I here consent to the disclosure of my personal information to OSHC Provider (if I purchased my
Overseas Student Health Cover via AUG) and the academic institution/s, I am applying to and receiving
communications from AUG regarding my application status as well as invitations and information about
AUG’s marketing initiatives and activities. I understand that AUG will keep my personal information
confidential and will be used according to the AUG Privacy Policy
I hereby declare that all information and documents I provide to AUG are true and original.
I hereby agree that my file and information will be made accessible to all employees of AUG.
I hereby acknowledge that AUG has provided me with accurate, current and honest advise matching my
personal circumstance and preferences.
I hereby agree that a student visa grant is not a guarantee and visa decision will depend on the respective
criteria assessment of the Immigration Office/Embassy.
I must keep confidential and will not disclose the terms of this agreement.

Student's Signature Over Printed AUG Counsellor's Signature over Printed

Name (Parent / Guardian if under 18) Name Date