Application for Admission
to Degree Program
Text Box: File No.
RMIT INTERNATIONAL UNIVERSITY VIETNAM
All sections with * MUST be completed
Section 1 Name & Contact Information
Family Name * Date of Birth(dd/mm/yyyy): *
Given Name/s * Male   Female *
Address Residential Number& Street name * District *
City/Province * Country *
Telephone * (area code) Mobile phone
Email *
Mailing Address Number& Street name District/ City/ Suburb
(if different from above) State Postcode Country
Area Code Telephone Facsimile
Country of Citizenship *
Country of Residence *
Agents Are you applying through an agent? Yes No
Agent's Name:
Agent's address:
Priority Enrolment Do you have a Certificate of Priority Enrolment issued by RMIT Vietnam and Bao Minh CMG Yes No
If yes, please attach a copy of the Certificate. The year of priority enrolment is: 
Section 2 English Language Proficiency (all Students must complete this section)
English Language
Studies Is English your first language?* Yes (if yes, go to Section 3) No
Have you studied at secondary or tertiary level with English as the medium for instruction?
(for example, University Foundation Program) Please provide evidence.
Yes No
If you are enrolled, or are planning to enrol, in English Language studies, give details below:
Date of Course (dd/mm/yyyy) Level: Institution
IELTS & TOEFL scoresor RMITEnglish test Have you taken an English test in the past 2 years? Yes No English test name
Date taken (dd/mm/yyyy): Result (if known): Please include a copy of the English test result
Section 3 Please list your program preferences in order of priority (1= first preference).
Name of Ungraduate/Postgraduate Program		 Commencement Date
(year/semester)
*
Your first preference will be processed first. Second and third preferences will be processed only if your first choice is unsuccessful.
English Program Only You would like to study English ONLY, not diploma or degree programs at RMIT Vietnam Yes No
Academic pathway
(For undergraduates students)		 Please indicate your pathway preference (RMIT University Entrance Program UEP or Advanced English L6): UEP English L6
Exemptions Are you applying for exemption (credit for subjects studied in another program)?* Yes No
If yes, please provide descriptions of relevant courses.
Scholarships Are you applying for a scholarship?* Yes No
If yes, please specify the scholarship program you are applying for:
Sponsorships Are you being sponsored by your employer?* Yes No
If yes, please specify your employer's name:
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