Centre for Australian Indigenous Research & Studies

University Preparatory Program (UPP)

APPLICATION FORM[1]

SECTION 1: PERSONAL INFORMATION

PERSONAL DETAILS

Family nameGiven name/s

Preferred nameDate of birth/ /

Gender: Male □ Female □ Transgender □ X (indeterminate, intersex, unspecified) □

Are you a(n): Australian citizen? □Aboriginal or Torres Strait Islander? □New Zealand Citizen? □ Permanent Resident in Australia? □ Holder of a Permanent Humanitarian Visa? □

ADDRESS AND TELEPHONE NUMBERS

*Current home address

Suburb State Postcode

Telephone ( )*Mobile

*Email address

*These fields are compulsory

Mailing address (if different from above)

Suburb State Postcode

If you have provided an interstate address (outside of South Australia) please see below. Your application is not judged based on the below information but helps provide a clearer understanding of your transition into the University as there are often events before classes officially begin.

Is your move to South Australia dependant upon your acceptance into the UPP?

Please provide the date you expect to arrive in South Australia.

EMERGENCY CONTACT DETAILS(someone we can contact in an emergency)

Name Relationship to you

Address

SuburbState Postcode

Telephone ( ) MobileWork ( )

DEGREE PROGRAM

What degree are you interested in studying at the University of Adelaide? (E.g. Bachelor of Arts, Bachelor of Science). If you are unsure what specific degree you wish to study, please write ‘Open Pathway’.

SECTION 2: EDUCATION AND TRAINING

PRIMARY AND SECONDARY EDUCATION

What level of schooling did you complete? Year_____When did you complete your schooling?

If you completed Year 12 or equivalent in the past seven years, please list subjects and results you attained:

FURTHER EDUCATION

Have you attended a TAFE program/s?Yes □No □

TAFE Campus:

Program/s studied*:Year

Completed Yes □No □

Or studied with another Registered Training Provider (RTP)?Yes □No □

Registered Training Providers name:

Program/s studied*:Year

Completed Yes □No □

Have you studied at University? Yes □No □

University name:

Program/s studied*:Year

Completed Yes □No □

Have you studied with another Institution not mentioned above?Yes □ No □

Institution name:

Program/s studied*:

Completed Yes □No □

*Please attach copies of your transcripts to this application. Note that credit transfer, or recognition for prior learning, may be granted in some cases (but will require appropriate documentation).

SECTION 3: EMPLOYMENT AND WORK EXPERIENCE

PREVIOUS EMPLOYMENT HISTORYList your employment history including the length of time in each position.

Employer:

Position: Employed Years Months

Employer:

Position: Employed Years Months

Employer:

Position: Employed Years Months

Employer:

Position: Employed Years Months

WORK EXPERIENCE / VOLUNTARY COMMUNITY ACTIVITIESProvide details of any work experience or voluntary community activities if applicable.

Are you currently employed? Yes □No □

If yes, how many hours per week do you currently work?____ per week.

If no, do you plan on looking for work during your UPP studies? Yes □No □

Do you plan on studying the UPP Full-time or Part-time?

□ Full-time^□ Part-time*

^Full-time study consists of three or four courses (subjects). Including class time and working on assessments, full-time study is the equivalent of full-time work (approximately 40 hours per week).

*Part-time study consists of one or two courses (subjects). Including class time and woking on assessments, part-time study is the equivalent of approximately 20 hours of study per week.

SECTION 4: STUDY INTERESTS, MOTIVATION AND CHALLENGES

Please write a short paragraph (up to 250 words) on your plans and goals in learning. You may wish to consider the following questions:

Other than gaining entry to university, what will the UPP help you achieve?
What do you want to study after the UPP and why?
Consider your current working and/or family commitments.What may change when you commence study in the UPP?

Your application to the UPP will be considered in relation to this paragraph, but you will not be ranked on the basis of it.

(Please provide as much detail as you can, and feel free to attach another sheet if you wish).

......

What challenges do you think you might encounter when undertaking University study?

(Please do not disclose any personal health, medical or disability information here. If you have these requirements, please contact Student Life Disability Supportat soon as possible as they will be able to discuss your specific requirements confidentially).

......

How do you plan to effectively address the challenges identified above?

......

The following activities are common in university classes and study but not are specific to the UPP:

Regular attendance
Group Work
Group Assessments
Examinations
Ongoing and formal assessments
Tutorial participation
Presentations
Placements/Internships
Fieldwork

If you feel you may require reasonable adjustments for any these activities, please contact and register with Student Life-Disability Support

The nature of your disability discussed wtih Student Life-Disability Support is kept strictly confidential.

SECTION 5: NON-AWARD STUDY

The UPP is a non-award degree program. Non-award students are formally enrolled in University of Adelaide courses (subjects). Studies students undertake will be recorded on an official University of Adelaide transcript. They are assessed in the same way as award students, and are bound by all relevant University Statutes, Regulations, Rules and Policies, Student Code of Conduct and other conditions relating to students. Non-award students will be required to observe the academic dates set by the University (i.e. withdrawal and census dates). Critical dates are published at . Non- award students will have access to online and library resources necessary for their studies. UPP students will be assured a place in selected University of Adelaide degree programs upon successful completion of the UPP.

SECTION 6: DECLARATION (for all students)

I certify that to the best of my knowledge all documentation and information submitted or made available by me in connection with this application is true, accurate and complete. I acknowledge that the provision of inaccurate or incomplete information may result in the withdrawal of any offer of enrolment or the cancellation of any enrolment allowed on the basis of acceptance of that offer. I authorise the University of Adelaide to obtain my academic record from other educational institutions if required.

Signature: ……………………………………………………………………………………Date: ………………………..

SECTION 7: FOR STUDENTS UNDER THE AGE OF 18

ACCESS TO THE INTERNET FOR STUDENTS UNDER THE AGE OF 18

PARENTAL CONSENT FORM

To students:

Under the Broadcasting Services Act 1992, the University must obtain the consent “of a parent, teacher or other responsible adult” before granting internet access to students under the age of 18. All University students, regardless of age, have access to University online resources. These include the enrolment web site, MyUni, library resources, email, the student dialup facility and other University of Adelaide web sites. However, students under the age of 18 will not automatically be provided with access to the wider internet, particularly world wide web sites outside the University. The University has determined that, in order to meet itsobligations under the Act, parental consent must be obtained before students under the age of 18 are provided with access to the wider internet. The University points out that students’ access to the internet will by and large be unsupervised, though it may be monitored from time to time to ensure compliance with the University’s policies and rules.

Any student under the age of 18 years who wishes to obtain access to the internet must ensure the agreement below is signed by their parent or guardian and submit the form attached to their UPP Application Form.

The student will be able to access the wider internet by the start of Orientation Week (“O-Week”) or, if the form is returned after the start of O-Week, on the following business day.

To Parents/Guardians:

This agreement indicates that you consent to the provision of access to the internet to the student whose parent or guardian you are. Prior to signing this agreement, please read and make sure that you and the student understand the University’s Information Technology Acceptable Use Policy. The policy can be viewed at:

Users of the University’s facilities also have certain rights and obligations under the Broadcasting Services Act 1992. The Internet Industry Association has developed a web site to provide the general public with information about their rights and obligations. You may access the web site at:

I declare that I am the parent or guardian of the student named below. I acknowledge that the student and I have read and understood the University’s Information Technology Acceptable Use Policy and agree to abide by the policy, as varied from time to time. I acknowledge that I understand my rights and obligations, and those of the student, under the Broadcasting Services Act 1992. I give consent for the student to have access to the internet in accord with the requirements of the Broadcasting Services Act 1992.

…………………………………………………….. ………………………………………

Student Name

……………………………………………………………………………………………...

Parent/Guardian Name(please print)

……………………………………………………………………………………….………………………………………

Parent/Guardian Signature Date

SECTION 8: APPLICATION PROCESS

Please email your application form to the Faculty of Arts Office:

Faculty of Arts

Ground Floor, Napier Building
THE UNIVERSITY OF ADELAIDE
SA 5005
AUSTRALIA

Phone:+61 8 8313 5245
Email:

Next steps...

Once your application has been received it will be assessed by the Program Coordinator and if accepted you may be invited to an interview about a month before the beginning of semester. If accepted, you will be sent a Welcome Letter from the University with the information you require to enrol andwill also be invited to an Enrolment Information session on the North Terrace Campusabout a week before semester starts.Please bring your Welcome Letter to the Enrolment Information Session.Classes will start in line with University semesters (see It is important your regularly check your email address in the weeks leading to enrolment and semester beginning as this is the primary means the university will contact you before classes begin.

UPP APPLICATION FORMPage 1 of 7

[1]Please note: all information given on this form will be treated with the strictest confidentiality and is only used for the purposes of administering your admission and enrolment into the UPP and for planning services. All information is stored on secure University servers.