Agriculture Enrolment - Marcus Oldham College

Step 1 of 14

Offer of Enrolment

Bachelor of Business(Agriculture)

Course ID – CRS1201331

By completing this form, I accept the offer of enrolment by Marcus Oldham College (ABN 50 071 444 409), a company limited by guarantee, of a place in the Bachelor of Business (Agriculture) program, for entry in the year 2025.

Student Details

Student Number*

You can find this at the top of your offer letter

USI Number*

(Unique Student Identifier) www.usi.gov.au

Full Legal Name*

First Middle Last

Please enter your name so it matches the name on your official birth certificate/passport.

Gender*

Female

Male

Indeterminate/Intersex/Unspecified

Date of Birth*

Please enter your full date of birth including complete year

Mobile*

Home Phone

Personal email*

Please provide a personal email address.

Residential Address*

Street Address Address Line 2 City State / Territory Postcode Country

Please add Property/Station name to Address line two if applicable

Is your postal address the same as your residential address?*

Yes

Postal Address*

Street Address Address Line 2 City State / Territory Postcode Country

Please add Property/Station name to Address line two if applicable

Residential Accommodation

Please indicate your intention regarding residential accommodation*

I wish to live on-campus

I will be a non-residential student

I acknowledge that Marcus Oldham College has no obligation to provide student accommodation; however, the College does have limited student accommodation facilities with rooms being subject to allocation following receipt of payment of deposit and return of all acceptance paperwork. I further acknowledge that should all rooms be allocated; Marcus Oldham College has no responsibility to arrange alternative accommodation. If this situation arises, it is my responsibility to organize my own accommodation, and I shall be placed on a waiting list and advised if a room becomes available in the Marcus Oldham facilities.*

I agree to the following

I acknowledge that Marcus Oldham College has no obligation to provide student accommodation; however, the College does have limited student accommodation facilities with rooms being subject to allocation following receipt of payment of deposit and return of all acceptance paperwork.

I further acknowledge that should all rooms be allocated; Marcus Oldham College has no responsibility to arrange alternative accommodation. If this situation arises, it is my responsibility to organize my own accommodation, and I shall be placed on a waiting list and advised if a room becomes available in the Marcus Oldham facilities.

Parent/Guardian Details

Could you please provide the following information in relation to parents/guardians? This information is part of a reporting requirement by the Commonwealth Government, Department of Education, Employment & Workplace Relations (DEEWR). This information will only be given to DEEWR.

Parent/Guardian 1*

First Last

Date of Birth*

Day

Month

Year

Please enter full date of birth including complete year.

Relationship to you*

Mobile*

Home Phone

Email*

Postal Address*

Street Address Address Line 2 City State / Territory Postcode Country

Please add Property/Station name to Address line two if applicable

Highest level of Education achieved*

I have:*

Parent/Guardian Details

Parent/Guardian 2*

First Last

Date of Birth*

Day

Month

Year

Please enter full date of birth including complete year.

Relationship to you*

Mobile*

Home Phone

Email*

Postal Address*

Street Address Address Line 2 City State / Territory Postcode Country

Please add Property/Station name to Address line two if applicable

Highest level of Education achieved*

Payment of Fees

Fee Payer Details

Name of Fee Payer

First Last

Mobile*

Home Phone

Email*

Accounts will be emailed unless postal requested.

Postal Address*

Street Address Address Line 2 City State / Territory Postcode Country

Please add Property/Station name to Address line two if applicable

Fee Payer Declaration*

I agree

In consideration of your offering, at my request, the above-named student enrolment at Marcus Oldham College, I agree to be jointly and severally liable with him/her for payment of all fees and contributions payable by him/her to the College. Any concession for extension of time you may grant to the student for payment of fees and contributions shall not affect this guarantee.

Fee Payer Signature*

Finance Agreement

Please read the finance agreement here.

Declaration*

I declare I have read and understood the Finance Agreement linked above

How will your fees be paid?*

To enable the College to correctly and efficiently administer payment of student fees would you indicate below what method you will use to pay your fees:

Full Fee-Paying Student

Full Fee-HELP Student

Partial Fee-HELP Student

Please provide bank account details for refunds and credits.

Bank Name*

BSB*

Account number*

Account Name*

Remember that FEE-HELP student loans do not cover Residential Fees and Charges. See www.studyassist.gov.au for complete information on FEE-HELP.

Declaration*

I agree to be bound by these terms and conditions

I certify that I have read and understood the Terms and Conditions of this Agreement. and certify that I agree to be bound by these Terms and Conditions.

Name*

First Last

Student Signature*

Student Medical Information

The information provided on this form is necessary for the College to ensure both your well-being and safety, and that relevant college staff are aware of current medical conditions that may arise during your stay at Marcus Oldham College. Please be assured that the College in no way discriminates against students who may be affected. All information collected and held within Marcus Oldham College shall only be used for the primary purpose for which it was collected. Information is securely held by the Student Services Officer and only disclosed to academic or administration staff as required. Please complete the below fields accurately and attach any relevant medical/treatment plans.

Do you have any dietary requirements?*

e.g. Dairy, Coeliac, Gluten, Vegetarian, FODMAP etc.

Yes

Please detail any dietary requirements you may have.*

Allergies – Do you have allergic reactions to anything including food?*

Yes

e.g. Anaphylaxis, Bee-Stings, Nuts etc

Please detail any allergies you have*

Are you affected by any of the following?

ADD/ADHD

Autism

Asthma

Diabetes

Epilepsy

Hearing impaired

Learning Assistance

Mental Health Condition

Physical Disability

Sight impaired

Other - Please name and give details

If you have a management plan(s) for your medical condition(s), please upload

Drop files here or

Max. file size: 5 MB.

Please detail any condition selected.*

Medicare Number*

Position on Medicare card*

Valid to:*

Do you have Private Health Insurance?*

Yes

Name of Fund*

Fund membership number:*

Do you have Ambulance cover?*

Yes

Membership coverage number*

Statement of medications currently being used*

It is important that the College has information from students who have medical conditions, and the plan for their conditions and the type of medications you are taking. It must be stressed that if you change your medication throughout your time at the College, the Student Services Officed be notified so that your medical record can be updated.

I am taking no regular medication

I am currently using the following medications

Please list all medications and including dosage amount*

In the event of illness or accident I authorise the person in charge, where it is impracticable to communicate with my emergency contacts, to consent to such medical and surgical treatment (including the administration of an anaesthetic) as may be deemed necessary by a legally qualified medical practitioner.

Student Signature*

Student Emergency Contact Details

Emergency Contact 1*

First Last

Relationship to student*

Mobile*

Emergency Contact 2*

First Last

Relationship to student*

Mobile*

Student Vehicle Information

This is the vehicle you are bringing to College. You must keep you vehicle details up to date with the College

I am*

Bringing a vehicle to College

Not bringing a vehicle to College

Vehicle Registration Number*

State Vehicle is Registered*

Vehicle Make*

Vehicle Model*

Vehicle Year*

Vehicle Colour*

COVID Declaration

It is recommended that any Staff or Students attending the College be Fully Vaccinated against COVID-19.

The College recommends that vaccination be undertaken on the advice of an accredited health practitioner (including health practitioners at any authorized COVID-19 vaccination centre).

For College sanctioned off-campus activities that involve members of the public (for example study tours), staff and students who facilitate these activities must consider CovidSafe measures including vaccination as part of the risk assessment for that activity.

Are you fully vaccinated against COVID-19?

Yes

Prior Criminal History

Have you ever been convicted, been found guilty of charges with a criminal offence?*

Yes

Please provide details and attach any relevant documentation. We may require you to provide a consent for a police check.*

If any personal details provided change prior to your arrival at, or return to the College, please advise the Student Services Officer by email at courses@marcusoldham.vic.edu.au If you have any questions or concerns, please contact the Student Services Officer by email or by phone at 03 5247 2911

Declaration*

I agree to the following

I have read the obligations detailed here, and I agree to be bound by them and by any amendments to them that have been notified to me in writing and to which I have agreed.

I have accepted my place by paying my acceptance fee by direct deposit into the College account, paid by credit card or posted a cheque for $1000.

This personal information will be held by the College to manage your progress through your chosen course. If any of these details change prior to your arrival at the College to commence your course of study, would you please inform us to enable us to update our records.

I acknowledge that the personal information provided by me will be held securely and my privacy respected, that this information may be used to keep me informed of College activities and that Marcus Oldham College has the right to discuss my academic performance with the fee-payer.

I agree to the College using my photograph, and or statements made by me in College publications and media advertising.

I have/or agree to apply for a current passport to enable me to travel internationally as part of my course of study.

I understand that the information collected on this form is to enable Marcus Oldham College to assess my application, create a record on its student records system, undertake statistical analysis and meet statutory reporting requirements. This information will be accessed by Marcus Oldham staff strictly for these purposes and disclosed to State and Australian Government agencies where required by law and the Fund Manager of the ESOS Assurance Fund as required under the Education Services for Overseas Students (ESOS) Act 2000 and the National Code 2007 of that Act.

Name*

First Middle Last

Signature of Student

Acceptance Fee Payment

To confirm your acceptance, we require the payment of an acceptance fee of $1000.00. This acceptance fee is non-refundable. If you commence your studies at the beginning of your enrolled year, the acceptance fee will be credited to your fee account. Payment is accepted by Credit Card, Direct Deposit and Cheque.

I would like to make my payment by:*

Credit Card Online

Credit Card by Phone

Direct Deposit

Cheque

Acceptance Fee

Price:

Total

Credit Card*

MasterCard

Visa

Supported Credit Cards: MasterCard, Visa

Card Number

Expiration Date Month Year

Security Code Cardholder Name

If you would like to pay by credit card by phone, please call our Finance Officer, Cathy Bent, on 03 5247 2905. Cathy is available Monday to Friday, 9:00 - 4:30pm AEST.

Please make a payment to the following account and include your surname and student ID as the payment description.

BSB 013-523

Account: 2538 603 16

Account Name: Marcus Oldham College

Please send a cheque made out to Marcus Oldham College to:

Private Bag 116, Geelong Mail Centre, Victoria, 3211, Australia