EmailMe Form - VET Student Loans Application Form

First Name *

Surname *

TAFE Student ID (if known)

I have read the VET Student Loan Booklet *

Yes

No

Email *

Mobile Number *

Alternative Phone Number

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Gender *

Male

Female

Other

Prefer not to say

Birth Date *

DD / MM / YYYY

List the course information that you have applied for.

Course Code *

Course Title *

Campus *

Have you previously enrolled into this course at another provider? *

Yes

No

Have you been known by any previous names?
(provide details)

Residency status *

Australian Citizen

NZ Citizen

Permanent Humanitarian Visa

Country of birth? *

Did you complete Year 12? *

Yes

No

School Title *

Even if you did not complete Year 12, please list the last secondary school you attended.

School Suburb *

Year completed school

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