StudyNet - Sub Agent Application Form Indonesia

Agent Information

Agent Type *

Onshore (Australia) Offshore

Please select an agent type.

Agent Name *

This field is required.

Agent Email *

Enter a valid email address.

Offshore Agent Country

Please select a country.

Student Information

Title

First Name *

First name is required.

Last Name *

Last name is required.

Date of Birth *

A valid date of birth is required.

Gender

Email *

Enter a valid email address.

Contact Number *

Enter a valid phone number.

Place of Birth

Zoom / Skype ID

Nationality *

Please select your nationality.

Country of Residence *

Please select your country of residence.

Student USI

State (Australia)

Marital Status *

Please select your marital status.

Marital Status Document

Click to upload

Do You Have Any Illness / Disability? *

Yes No

Please select an option.

Brief Description of Illness / Disability *

Please provide a brief description.

Statement of Purpose (SOP)

Upload SOP (PDF, DOC, DOCX)

Address Details

Australian Address

Street Address *

State *

Suburb *

Post Code *

Overseas Address

Street Address *

Suburb *

Post Code *

State *

Country *

Education Enquiry

Date of Arrival in Australia

Currently Studying in Australia?

Yes No

Current Course Name

Current Provider Name

Enquiry / Comments

Interested Course

Interested Course *

Interested course is required.

Interested Level of Study *

Please select the level of study.

Preferred Location *

Preferred location is required.

Provider / Institution Name *

Provider / institution name is required.

Intake Month *

Please select the intake month.

Intake Year *

Please select the intake year.

Add Another Interested Course?

Yes No

Interested Course 2

Course Name *

Course name is required.

Level of Study *

Please select the level of study.

Preferred Location *

Preferred location is required.

Provider Name *

Provider name is required.

Intake Month *

Please select the intake month.

Intake Year *

Please select the intake year.

Education Background

RPL — Recognition of Prior Learning

Are You Applying for RPL? *

Yes No

Please select an option.

Transcript for RPL

Upload transcript

Syllabus for RPL

Upload syllabus

Education Background — Course 1

Course Name *

Course name is required.

Level of Study *

Please select the level of study.

Institution Name *

Institution name is required.

Country *

Please select the country.

Course Status *

Please select the course status.

Start Date

End Date

CGPA / Score

Academic Transcript

Upload

Completion Letter

Upload

Academic Certificate

Upload

Start Date

Expected End Date

Reason Not Started

Cancellation Date

Cancellation Reason

Withdrawal Date

Withdrawal Reason

Add Another Course?

Yes No

Education Background — Course 2

Course Name *

Course name is required.

Level of Study *

Please select the level of study.

Institution Name *

Institution name is required.

Country *

Please select the country.

Course Status *

Please select the course status.

Start Date

End Date

CGPA / Score

Academic Transcript

Upload

Completion Letter

Upload

Academic Certificate

Upload

Start Date

Expected End Date

Reason Not Started

Cancellation Date

Cancellation Reason

Withdrawal Date

Withdrawal Reason

Add Another Course?

Yes No

Education Background — Course 3

Course Name *

Course name is required.

Level of Study *

Please select the level of study.

Institution Name *

Institution name is required.

Country *

Please select the country.

Course Status *

Please select the course status.

Start Date

End Date

CGPA / Score

Start Date

Expected End Date

Reason Not Started

Cancellation Date

Cancellation Reason

Withdrawal Date

Withdrawal Reason

Sponsorship Details

Do You Have a Sponsor?

Yes No

Annual Study Budget

Sponsorship Type

Relation Type

Fund Type

Fund Maturity Date

Sponsor Occupation

Annual Income

Source of Income

Sponsor Full Name

Sponsor Other Name

Sponsor Email

Sponsor Contact Number

English Test Details

Have You Taken an English Exam?

Yes No

Test Type

Date of Test

Specify Other Test

Reading Score

Writing Score

Listening Score

Speaking Score

Overall Score

Upload Test Result

Upload result

Other Language Proficiency?

Yes No

Specify Other Language

Professional Membership & Work Experience

Professional Membership

Are You a Member of Any Professional Organisation?

Yes No

Professional Membership Details

Work Experience

Are You Currently Working?

Yes No

Work Experience 1

Company Name

Position / Designation

Start Date

End Date

Country

Employment Document

Upload document

Add Another Work Experience?

Yes No

Work Experience 2

Company Name

Country

Start Date

End Date

Position / Designation

Employment Document

Upload

Passport & Visa Details

Passport Details

Passport Number *

Passport number is required.

Issuing Country

Issue Date

Expiry Date

Upload Passport

Upload passport scan (PDF / JPG)

Visa Details

Do You Have a Visa?

Yes No

Visa Type

Specify Other Visa

Visa Number

Visa Subclass

Visa Issue Date

Visa Expiry Date

Upload Visa

Upload visa document

Have You Had a Visa Cancelled Before?

Yes No

Provide Details

Upload Supporting Document

Upload document

Health Insurance (OSHC)

Do You Have Health Insurance (OSHC)?

Yes No

Insurance Provider

Insurance Type

Policy Start Date

Policy End Date

Policy / Reference Number

Upload Insurance Document

Upload

Emergency Contact Details

Contact Name *

Contact name is required.

Contact Email

Enter a valid email address.

Relationship

Contact Phone Number *

A valid phone number is required.

Student Declaration & Submission

By submitting this form, you declare that all information provided is true, correct and complete. You authorise StudyNet to use this information for the purposes of processing your application. False or misleading information may result in your application being rejected or cancelled.

Student Declaration I appoint STUDYNET PTY LTD, Sydney Office as my agent to process my application. I declare that the information and documents I have provided to the agent for the purpose of this application are authentic and correct. I also declare that I will keep my agent updated in a timely manner about any changes.

I authorize my agent, STUDYNET Sydney Office, to verify the application documents. I am willing to cooperate in providing any documents required by my agent for my application.

I acknowledge that any incorrect, misleading, or fraudulent information, or withholding of relevant information at any stage of my application, may lead to refusal of my school application.

I confirm that all relevant documents, including but not limited to the application form, GTE form, acceptance form, payment form, financial declaration form, and credit card authorization, have been signed by myself or by my parents if I am under 18. *

You must agree to the declaration.

Student Signature (Type Full Name)

Privacy Policy & Terms I agree to the Privacy Policy and Terms & Conditions. *

You must agree to the privacy policy.

Sub Agent Application Form - Indonesia

Agent Information

Student Information

Address Details

Education Enquiry

Education Background

Sponsorship Details

English Test Details

Professional Membership & Work Experience

Passport & Visa Details

Health Insurance (OSHC)

Emergency Contact Details

Student Declaration & Submission