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Applicant Details

Surname

Given Name(s)

Sex

Male

Female

Indeterminate

Date of birth

Passport Number

Country of birth

Citizenship

Visa Type

Visa Expiry

USI

Address

City

Postcode

Telephone

Mobile

E-mail

Education Background
List details of your previous education including highest level of education and current studies. Please attach relevant documentation from all studies undertaken(e.g. High school, Advanced Diploma/Diploma/Degree.)

High School(Senior School)

What level have you achieved

Year you finished High School

Post-Secondary Education

Qualification

Qualification1

Qualification2

Name of the institute

Name of the institute1

Name of the institute2

Country

Country1

Country2

Year of Award

Year of Award1

Year of Award2

English Proficiency
Have you taken a recognized English language test, such as IELTS? If yes, Please complete the details below and provide a certified copy of your test results

English Test

Results

Date of test

Agent Information

Will you be applying through agent?

Yes

Agency Name

Consultant Name

Phone No.

ELICOS Enrolment Details (English Courses recommend start on week1. * but ask about alternative intakes if necessary)

Courses

General English (6-72 weeks)

EAP (English Academic Purpose)

Intensive English & Proficiency testing (6-52 weeks)

Number of weeks

Preferred Start Date

Vocational Courses and Commencement dates

Visa office details (if applicable)

Overseas Student Health Cover option

WIN to arrange?

Yes

the Health Cover Information：

Overseas Student Health Cover	Single	Family
6Months	$278.00	$2559.00
12 Months	$556.00	$2831.00

WIN Bank Details

Account name: George Education Pty Itd

BSB: 062 033

Acc No: 10521258

Bank: Commonwealth Bank

Bank Address: Elizabeth & Foveaux Streets, Sydeny NSW 2010

SWIFT Code: CTBAAU2S

WIN College (Vocational)

George St Campus: Level 3, 695 George Street, Haymarket NSW 2000

WIN Higher Education

Surry Hills Campus: Level 1-5, 302-306 Elizabeth Street, Surry Hills NSW 2010

WIN English Centre

Pitt St Campus: Level 7,451 Pitt Street. Haymarket NSW 2000

Email : info-george@win.edu.au

Web: www.win.edu.au

Tel: 02 8252 9999

Fax: 02 8252 9988

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WIN Bank Details

WIN College (Vocational)

WIN Higher Education

WIN English Centre

Information Summary