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Online Application

Please make sure you complete ALL sections of this form. Tick boxes where appropriate. Please submit a copy of your passport with your completed application form. Incomplete applications will cause processing delays.

Personal Information

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Given Name Family Name
Date of Birth
Country of Birth
Nationality
Passport Number Upload Passport Copy

(.JPEG .PNG or .PDF only. Maximum size 5MB.)

Upload Supporting Documents (if required)

(.JPEG .PNG or .PDF only. Maximum size 5MB.)

VISA TYPE:

Visitor Working Holiday Student Other

If Other:

IF Student (OSHC/insurance required?): YES NO

IF YES - OSHC/insurance type: SINGLE COUPLE FAMILY

Contact Information

Address Line 1 Address Line 2 Suburb / Town / City Provice / State Country Postcode Email

This will be used for your ICON login. Please provide the email address that you will use in Australia.

Phone Mobile

TPS Payment Option (for applications over 25 weeks)

Do you want to pay with TPS instalment plan? YES NO

Please refer to Impact's TPS Information Sheet for more details.

Enrolment Information

COURSE 1

General English Business English IELTS/EAP Extreme English Cambridge FCE Cambridge CAE Barista & Cafe English
CAMPUS BRISBANE MELBOURNE
Starting Date:
Weeks:
Holiday Dates (subject to approval):

COURSE 2

General English Business English IELTS/EAP Extreme English Cambridge FCE Cambridge CAE Barista & Cafe English
CAMPUS BRISBANE MELBOURNE
Starting Date:
Weeks:
Holiday Dates (subject to approval):

COURSE 3

General English Business English IELTS/EAP Extreme English Cambridge FCE Cambridge CAE Barista & Cafe English
CAMPUS BRISBANE MELBOURNE
Starting Date:
Weeks:
Holiday Dates (subject to approval):

COURSE 4

General English Business English IELTS/EAP Extreme English Cambridge FCE Cambridge CAE Barista & Cafe English
CAMPUS BRISBANE MELBOURNE
Starting Date:
Weeks:
Holiday Dates (subject to approval):

COURSE 5

General English Business English IELTS/EAP Extreme English Cambridge FCE Cambridge CAE Barista & Cafe English
CAMPUS BRISBANE MELBOURNE
Starting Date:
Weeks:
Holiday Dates (subject to approval):

COURSE 6

General English Business English IELTS/EAP Extreme English Cambridge FCE Cambridge CAE Barista & Cafe English
CAMPUS BRISBANE MELBOURNE
Starting Date:
Weeks:
Holiday Dates (subject to approval):

Further Study/Pathway Information (if applicable)

Do you have a package visa application? YES NO

Institution:
Course name:
IELTS score entry requirement:
Course intake date:

Accommodation Information

Do you want Impact English College to arrange accommodation? YES NO

If yes, please complete the accommodation application form below.

Flight Details & Arrival Date

Flight Number:
Arrival Date:
Arrival time:
Arrival Airport Tullamarine Avalon Brisbane Gold Coast
Do you want Impact English College to arrange airport pick-up? YES NO
Notes (e.g. if check-in date is different from arrival date):

*Please note that Check-in and Airport Pick-Up bookings are not available from 23 Dec 2023 to 6 Jan 2024.

Preferred Accommodation Options

Please choose and complete relevant sections? Student Residence Homestay

Student Residence

Please choose: Melbourne Single Iglu Flagstaff Garden Melbourne Single Iglu South Yarra Brisbane Single Iglu Brisbane City Brisbane Single Iglu Kelvin Grove
Required weeks of stay: (minimum, 5 weeks)

*Due to the high demand for student residences, acceptance of the booking is subject to availability. Please check availability on our website for the earliest available date and contact homestay@impactenglish.edu.au before you proceed with the accommodation application. It is recommended to book for the maximum duration of your stay as it is highly unlikely that an extension of the stay can be arranged after your arrival.

Homestay

Please choose: Single Room Double Room

Required weeks of stay: (minimum, 4 weeks)

Impact acknowledges the importance of quality accommodation and will endeavour to meet student needs. However, we cannot guarantee that all preferences will be met as this is subject to availability

1. Do you smoke? YES NO

2. Are children under 16 years old in the household OK? YES NO

3. Do you have any allergies to animals or food? YES NO

If yes, please specify (please note that a majority of homestay families in Australia have pets):

4. Are there any foods you cannot eat? YES NO

If yes, please specify:

5. Do you need any regular medication? YES NO

If yes, please state the medical condition and medication type:

6. If you have any other special homestay requirements, please give details:

Accommodation Placement Fee and Airport Pick-up Terms and Conditions

Accommodation placement fees and airport pick-up fees will be refunded in full if no less than 28 days' written notice is given. With less than 28 days' notice, no refund will be made.
In the event of any changes to the flights, Impact needs to be notified on the emergency number provided in your airport pick-up information. If you do not notify the college, you may be asked to pay an extra fee.

Student Residence Terms and Conditions

Bookings are for a minimum 5-week period.
A full refund of the accommodation fee will be given if a booking is cancelled more than 30 days before arrival. No amendments or cancellations can be made within 30 days prior to arrival and after commencement of stay.
Students who choose to leave will not receive a refund for the term they applied for. Students can apply for the minimum stay of 5 weeks and extend their stay (this is subject to availability).
An exit cleaning fee of $150 will be charged at the time of your booking. Please refer to our accommodation flyers for further information.
Students must check-in on Sunday and check out by 12:00pm on Saturday. A full week will be charged otherwise. No daily fees available.

Homestay Terms and Conditions

Bookings are for a minimum 4-week period.
The first 4 weeks are non-refundable. 2 weeks' notice is required when you want to move out thereafter.
After commencement of the stay, students who choose to leave before the end of the minimum booking period will not receive a refund. After the initial 4 weeks, students must give 2 weeks' notice or pay for 2 weeks in lieu of notice.
Students who arrive before 6pm (Monday - Friday) may need to wait at Impact English College and find their own transport to the homestay as some providers may not be available to take students during these times.
If a student arrives between 12am and 6am, the start date of the homestay is one day before the arrival day.

I confirm that I have read and fully understood Impact English College's Accommodation Terms and Conditions and Accommodation Options flyer. I understand that I am responsible for any damage or loss of my property and I will be charged for repair (or replacement if necessary) of any and all damage that occurs in my room and common area.

Agent Details

Are you represented by an Education Agent? YES NO

If YES, please provide Agency Details below
Agency Name:
Branch:
Counsellor's name:

Student Declaration

I declare that the information contained in this application is true.
I confirm that I have received and read a copy of Impact English College's current brochure and fully understood and agree to the Terms and Conditions of Enrolment.
Name
Date

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Courses

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Barista/Café English
Cambridge FCE & CAE
IELTS/EAP
Business English

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Melbourne +61 3 9670 2840
Brisbane +61 7 3306 7610
Email info@impactenglish.edu.au
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