International Student Application Form*
* Alternatively, you can apply directly via our website.
Visit www.ecu.edu.au/future-students/international/overview for more details.
Please check one of the following:
First Application Change of Course
NAME AND CONTACT INFORMATION ECU Student Number (if applicable)
1. Surname (as shown on passport):__Sapkota
____________________________________________________________________________________
Abhaya
2. Given Names: ____________________________________________________ Preferred Name:___________________________________
3. Home Address: __New Baneshwor, Kathmandu, Nepal
______________________________________________________________
Agent Stamp/Contact Details
______________________________________________________________________________
______________________________________________________________________________
Mobile: __+977-9840139619
_____________________________________________________________________
[email protected] Email (Required): ______________________________________________________________
977(Area Code) 01
Telephone: (Country Code) _____ _____ (Phone No) __4481818
___________________
4. Correspondence Address (if different):____________________________________________
______________________________________________________________________________
______________________________________________________________________________
Telephone: (Country Code) ___ (Area Code) _____ (Phone No) ______________________
5. Date of Birth: D D
1 0 M 8 Y2 0
0 M Y 0
Y Y
1
6. Sex: Male Female
Nepal
7. Country of Birth:___________________________________________________________________________________________________
Nepal
8. Nationality/Citizenship:______________________________________________________________________________________________
PROPOSED PROGRAM Undergraduate Postgraduate
2021
9. Commencement Year: _____________________________________________ Semester 1 (Feb) Semester 2 (July)
10. Course Preferences:
Bachelor of Commerce
1st Preference: ______________________________________________ Accounting
Major: ____________________ W23
Course Code:____________
2nd Preference: Bachelor of Computer Science
_____________________________________________ Software Eng. Course Code: ___________
Major: ____________________ U65
ENGLISH LANGUAGE PROFICIENCY
Nepali
11. What is the main language spoken in your home?_______________________________________________________________________
12. Please provide proof of competence in English Language. You must attach evidence to show that your English ability meets our
requirements, eg. IELTS, TOEFL or Pearsons; GCE O Level.
Have you completed a degree or other tertiary qualification in English? Yes No
QUALIFICATIONS
13. Please attach copies of all academic records. A copy is a photocopy stamped and signed by a public notary or education
institution representative.
Please list all qualifications obtained starting from your final secondary year.
Country Completed Normal Course Years Attended
Name of Institution Name of Award
of Study Y/N Duration From/To
Vidhya Sanskar School Nepal NEB Y 2009 / 2017
Rato Bangala School Nepal GCE A-Levels Y 2017 / 2019
/
/
CRICOS Institution Provider Code 00279B.
OTHER INFORMATION
14. Disability Declaration: Do you have a disability or any longterm medical condition which may affect your studies? Yes No
If yes please indicate the area of impairment to enable the University to provide assistance:
Hearing Learning Mobility Vision Medical
Other: please indicate_______________________________________________________________________________________________
15. Home Country Emergency Contact
Mr. Family Name: _______________________
Title: ________ Sapkota Udaya Raj
Given Name: _______________________ Father
Relationship: __________________
+977-01-4481818
Telephone: ________________________________________________________________________________________________________
Address: __New Baneshwor 10, Kathmandu, Nepal
_________________________________________________________________________________________________________
16. Do you permit ECU to provide information to your nominated sponsor/guardian or scholarship body? Yes No
If so, please provide name of individual/scholarship body: __________________________________________________________________
RELEASE OF ACADEMIC RESULTS
17. If your application for direct entry into ECU is unsuccessful, it may be possible for you to be admitted to a course at a pathway
college associated with ECU. Successful completion of a qualification at the college is an alternative entry pathway into ECU.
Would you like us to pass your application to be considered for entry into a pathway course? Yes No
REQUIRED DOCUMENTS (Please check our website for course specific requirements)
All Students:
yy Application Form
yy Academic Documents
yy English Proficiency Documents
yy Copy of passport (if applicable)
yy Student Financial Declaration Form
I have attached the above mentioned documents Yes No
Research Students:
yy A brief outline of the research topic you wish to undertake (1-2 pages in length)
yy Copies of any published papers or journal articles – if available
yy Resumé (Curriculum Vitae)
I have attached the above mentioned documents Yes No
Have you approached or identified a potential supervisor?* Yes No
If yes, please provide name:_______________________________________________________________________________________________
* Please note that due to the number of applicants, there is no guarantee of supervision; supervisors will be determined by the Faculty once all applications
have been assessed.
DOCUMENT SUBMISSION
By email: [email protected]
In person: Edith Cowan University, 270 Joondalup Drive, Joondalup 6027, Western Australia.
Please note that you must include copies of your documents and official translated copies if the original is not in English.
DECLARATION
1. I declare that the information provided by me in this application is true and correct. I acknowledge that Edith Cowan University reserves the right to
make such enquiries as may be reasonably necessary to verify the information provided by me in this application including, with regard to my educational
qualifications.
2. I understand that providing false and misleading information to obtain admission and/or credit into a course is an offence.
3. I confirm:
a. I have made my own enquiries as to the suitability of the course that I am seeking to be enrolled; and
b. That it is my sole responsibility to ensure that my enrolment is in accordance with the Admissions Enrolment and Academic Progress Rules of Edith
Cowan University.
4. I acknowledge and agree that the information provided by me to Edith Cowan University may be provided to Commonwealth and State agencies when
required by law.
5. If I am admitted into a course with Edith Cowan University I agree to comply with the Statutes, By-laws, Rules and Regulations of Edith Cowan University.
6. I acknowledge I have had the opportunity to peruse the Statutes, By-laws, Rules and Regulations of Edith Cowan University at
www.ecu.edu.au/centres/office-of-governance-services/our-services/policy-and-legislation
7. I acknowledge that official communication by Edith Cowan University to me will be by electronic means unless alternative communication arrangements
have been agreed by ECU.
8. I agree to notify ECU of any changes to my residential addresses whether in Australia or another country and to any change in the contact information in
the event of an emergency.
If you have concerns about any of the above items please contact ECU via email at [email protected].
06/09/2020
Student Signature: _____________________________________________________________Date:____________________________________
Please note that we do not charge an application fee.
You can review the ECU Fees Refund Policy online by entering ‘refund policy’ in our search engine.
