Residence Application

Telephone/Facsimile/Email (include area code)

Within The University of Western Australia

Residence

How To Apply

ALL DETAILS MUST BE COMPLETED Clear Form

Title (Mr/Ms/etc)		Surname/Family Name

First given name		Second given name

Birth Date

3. Gender

4. Preferred first name

	Male
	Female

dd/mm/yy

Notification address
(acknowledgement, documents, offer advice will be sent to this address)
	Aust Postcode

Permanent home address
(if different from notification address)
	Aust Postcode

Citizenship and residency status
	Australian citizen
	Permanent resident of Australia but not Australian citizen
	None of these

If you answered ‘Yes’ to (ii) or (iii), state your country of citizenship.

Have you previously lived in a tertiary College or Hall?

If ‘Yes’, please give name and address.

10.

Choice of Residence
You can only apply to one College/Hall at a time. Please note that if you do not receive an offer from your preferred College you will be given the choice of remaining on that College's waiting list or having your application sent to the Joint-Colleges' administrative service for processing.
Preference	Code	College
1st

11.

What matriculation examination are you taking or have taken for admission to University?

(eg. TEE, A levels, IB etc)

List the subjects that you studied (or are studying) in your final year at school.
Subject	School Year	Grade/Mark

Provide the name and address of the secondary school that you last attended/are currently attending.
State the year that you last attended.

Year

12.

Are you currently enrolled and/or have you ever been enrolled in a diploma, associate diploma, Bachelor’s degree or postgraduate course at a tertiary institution?

	No
	Yes

If 'Yes' provide details
Institution	Course (e.g. Science)	Type (e.g. Bachelor)	Year(s) Enrolled	Student Number

13.

Choice of university courses/programmes
Preference	TISC Course Code (See TISC Guide)	Method of Study (F-Full, P-Part E-External)	Course/Programme	University	Year of Entry (e.g. first)
1st
2nd
3rd
4th

14.

When will you be starting your course?

	Semester 1 (Feb)
	Semester 2 (July)
Year

15.

Referees - List below the names and addresses of two referees Referees might be selected from your School Principal, Teacher, Minister or Parish Priest, etc DO NOT INCLUDE RELATIVES OR SCHOOL FRIENDS Referee report forms are available from your school, TISC or any of the Residential Colleges. YOU must contact the two referees listed below and ask them to complete a referee form and to return it to the Head of the College of your first preference. The referees must post the report to the College in a sealed envelope marked ‘Confidential-Referee’s Report’. You should not handle the referee’s forms yourself.
Name			Phone
Address			Postcode
Name			Phone
Address			Postcode

16.

Please supply details of parent, guardian or next of kin
Name			Phone
Address			Postcode
Relationship

Mother's Name			Occupation
Father's Name			Occupation

17.

Emergency PERTH contact (if available)
Name			Phone
Address			Postcode

18.

General Interests - Please provide as much detail as possible
Music
Art
Sport
Youth/ Community Groups
Religion
Hobbies
Leadership Roles
Other Activities

19.

Do you have any disability or chronic medical condition that will require
any special consideration (If ‘Yes’ attach a statement)

	No
	Yes

Declaration and submit

THE APPLICATION FEE ($50AUD for students living in Western Australia and $60AUD for students living interstate or overseas) AND 2 PHOTOGRAPHS MUST BE SENT TO ST. GEORGE'S COLLEGE FOR YOUR APPLICATION TO BE VALID

Send to:

St. George's College
Mounts Bay Road
Crawley WA 6009

I declare that I have read the information that accompanied this form and the information I have supplied in this application form is true and correct. I authorise the Colleges to obtain any other information which will assist them in deciding the outcome of my application.

Click here to Submit the Application


St George’s College - Mounts Bay Road, Crawley WA 6009 \| Email: admin@stgeorgescollege.com.au \| General Enquiries Tel: 08 9449 5555 (Aust) +61 8 9449 5555 (Int) \| Fax: 08 9449 5544 (Aust) +61 8 9449 5544 (Int)