Student Information Form

To ensure the smooth processing of the application, please provide the following information and
make sure that it is genuine and correct. We guarantee that the information will not be disclosed to
any unrelated third party without your consent. Please provide as many details as possible. Thank
you for your cooperation.

Information of Student Recruitment Agency

★Agency Name St Bees Dongguan

★Counselor’s Email levana.lv@stbeesschool-dg.cn

Counselor’s phone

★必填信息
★Applicant’s Personal Information

Title Mr Date of Birth (DD/MM/YYYY)

Last Name MA First Name CHING YAN

Gender Male Phone 13825722485

Email（需提供学生的163 账 号 ：

Nationality China markucaks@163.com

邮箱用于做网申，并提供
账户和密码） 密码：

Home Address & Post Code：

Parents’ Information

马兴淦 13509820583
Father’s Name Phone

Occupation Email（可选填）

13922513155
Mother’s Name 陈玉霞 Phone

Occupation Email（可选填）

1
★Education History

From…To… 2021 to 2024 Completion Date (DD/MM/YYYY)

Institution Name & Address St bees dg

Qualification (A-level,IB,bachelor) international a level

Overall results Math C Econ A Psychology B

★Institution Choice

(Please enter the exact name on official website and specify the major, campus and course duration to apply for)

★Start Date （MM/YYYY）

★Institution Name 1 University of Sydney

★Course Website Link https://www.sydney.edu.au/courses/courses/uc/bachelor-of-economics.html

★Course economics

★Institution Name 2 University of Melbourne

★Course Website Link https://study.unimelb.edu.au/find/courses/major/economics/

★Course economics

★Institution Name 3 University of New South Wales

https://www.unsw.edu.au/study/undergraduate/bachelor-of-economics?
★Course Website Link
studentType=Domestic

★Course

★Institution Name 4 Australia National University

★Course Website Link https://programsandcourses.anu.edu.au/2024/program/BECON

★Course

★Institution Name 5 Monash University

https://www.monash.edu/study/courses/find-a-course/economics-b2031?
★Course Website Link
international=true

2
★Course

★Reference Information

★Reference Information-1

Full title and name of referee

Position Gender
Email
Phone
Workplace+Organization

Address & Post Code

How long have you known the applicant?

Relationship with the Applicant

★Reference Information-2

Full title and name of referee Position Gender

Email
Phone
Workplace+Organization

Address & Post Code

How long have you known the applicant?

Relationship with the Applicant

Passport Information（★注意：学校申请时候需要提供）

(Please provide a scanned copy of the applicant’s passport if available to ensure that correct information is
submitted for application)

Passport Number H22846 Date of Issue (13/01/2024) Date of Expiry (13/01/2034)

128

English Language Proficiency（带★是必填信息）

雅思查询密码
IELTS / Test Date ★(25/02/2024) 雅思查询用户名★ID:
★Code：

★TRF Number:

3
Total Score 7.0 Listening 8.0 Reading 6.0 Speaking7.0 Writing 6.0

TOFEL / Test Date ★(DD/MM/YYYY) ★ID: ★Code

Total Score 7.0 Listening 8.0 Reading 6.0 Speaking 7 Writing 6

.
Credit Card Information (If application fee is required and if we are authorized to use the card to pay
application fee on behalf of the applicant.)

Name on Card Type of Card (VISA or MasterCard)

Card Number

Date of Issue Expiry Date

Security Code (the last 3 numbers in the signature section on the back of the card)