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7/29/2019 Le Cordon Bleu Master of Gastronomic Tourism Direct Application Form (v20130305)
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Southern Cross University, PO Box 157, Lismore NSW 2480 | +61 7 5506 9342 | [email protected] | scu.edu.auLe Cordon Bleu Australia CRICOS Provider: SA 01818E, NSW 02 380M | Southern Cross University CRICOS Provider: NSW 0124 1G, Qld 03135E | This course is not available to international students studying in Australia
Direct Application Form
Le Cordon Bleu
Gastronomic Tourism
The Le Cordon Bleu Gastronomic Tourism courses are
delivered fully online by Southern Cross University via
the Universitys distance education study option.
How to Complete tHis Form
Hard-copy Printed FormsUse only a black pen and print clearly in BLOCK LETTERS. e.g.
j o h n C i t i z e n
For check-boxes please clearly cross the box, e.g.
Complete all details careully to avoid delays in processing your application.
Electronic Versions of this FormYou can ll in the orm electronically by typing into the orm, however,we still
require your signature you must print it so you can sign it beore mailing or
axing it to Le Cordon Bleu. I you want to email your application orm you must print
it, sign it, then scan it as a PDF or JPEG le beore emailing it to us on
supporting DoCuments
To avoid delays in processing your application please note the ollowing:
X Applications must include an original or certied copy o academic transcripts
or all post-secondary studies.
X Documentary evidence and ofcial translations must be supplied or all
overseas qualications.
ADvAnCeD stAnDing
Advanced Standing is recognition that prior study or experience has academic valueto your intended studies. For urther inormation please visitscu.edu.au/advancedstanding.
ContACt le CorDon bleu
For application enquiries, contact Le Cordon Bleu
By Telephone+61 8 8348 3058
By Fax+61 8 8346 3755
By MailLe Cordon Bleu Admissions OfceDays Road, Regency ParkSouth AustraliaAustralia 5010
Websitelecordonbleu.com.au
Send this application to:
Le Cordon Bleu Admissions Office
Days Road, Regency Park
South AustraliaAustralia 5010
http://www.scu.edu.au/mailto:australia%40cordonbleu.edu?subject=Enquiry%3A%20Le%20Cordon%20Bleu%20Master%20of%20Gastronomic%20Tourismhttp://www.scu.edu.au/advancedstandingmailto:australia%40cordonbleu.edu?subject=Enquiry%3A%20Le%20Cordon%20Bleu%20Master%20of%20Gastronomic%20Tourismhttp://www.lecordonbleu.com.au/http://www.lecordonbleu.com.au/mailto:australia%40cordonbleu.edu?subject=Enquiry%3A%20Le%20Cordon%20Bleu%20Master%20of%20Gastronomic%20Tourismhttp://www.scu.edu.au/advancedstandingmailto:australia%40cordonbleu.edu?subject=Enquiry%3A%20Le%20Cordon%20Bleu%20Master%20of%20Gastronomic%20Tourismhttp://www.scu.edu.au/7/29/2019 Le Cordon Bleu Master of Gastronomic Tourism Direct Application Form (v20130305)
2/4Le Cordon Bleu Australia CRICOS Provider: SA 01818E, NSW 02 380M | Southern Cross University CRICOS Provider: NSW 0124 1G, Qld 03135E | This course is not available to international students studying in Australia
5. Course inFormAtion
Course name: e.g. Master, Graduate Diploma, Graduate Certifcate, Unit o study (specifc unit) oFFiCe use only
1. personAl DetAils
I you have been a student o SCU, UNE NR, or NRCAE, what is your Student ID Number(i known):
Full ormal name (as per passport) or use on ormal documents, including degree certicate
Title: First Name: Other Given Name(s):
Last Name: Previous Last Name:
Preerred Name:
Sex: Male Female Date o Birth: Day Month Year
2. ContACt DetAils
Street Number and Name (or PO Box):
Suburb/Town: State: Postcode: Country:
Phone (home): Phone (work): Phone (mobile):Email Address:
3. CitizensHip DetAils
I you are a New Zealand citizen, the holder o a Permanent Humanitarian Visa, Temporary Entry Permit, or have been granted an Australian Permanent Resident Status,you MUST att ach a cert ifed copy o you r visa/pa sspor t confrming these deta ils. All app licants must meet the En glish langua ge requirements o Southern Cross Universit yas part o their eligibility or admission. Please reer toscu.edu.au/englishskills or urther inormation.
Country of Birth:
I not Australia or New Zealand:
Do you hold an Australian Permanent Humanitarian Visa? YES NO
Have you been granted Australian Permanent Resident Status? YES NO
Country o Citizenship:
Are you o Aboriginal or Torres Strait Islander descent? NO YES, Aboriginal YES, Torres Strait Islander YES, Aboriginal and Torres Strait Islander
4. DisAbility
Do you have a disability, impairmentor long-term medical condition thatmay afect your studies?
YES
NO
I YES, pleaseindicate area(s)o impairment:
Hearing Mobility Learning
Medical Other (please speciy)
Vision
Would you like to receive inormationon disability support services?
YES NO
Direct Application Form Le Cordon Bleu Gastronomic Tourism
6. englisH lAnguAge proFiCienCy
Main language spoken at home, i not English:
Have you completed a test o English prociency in the last 2 years? YES NO I YES please indicate the date taken and test
Date taken (dd/mm/yyyy) English test name Result (i known) IELTS test report orm number
When do you want to commence? (tick one)
Trimester A (January) Trimester B (May)
Trimester C (September)
Are you applying tochange courses at SCU?
YES NO
Note:To be eligible or a course transer you must be an SCUstudent currently admitted to a coursework award course.
Note: I your name has changed since previous enrolment at SCU, please reer toscu.edu.au/changeofname or inormation about documents required
Day Month Year
Day Month Year
IF YES,
please
indicate:
Please attach an original or certifed copy o test results.
Date Granted:
Date o entryinto Australia:
http://www.scu.edu.au/englishskillshttp://www.scu.edu.au/englishskillshttp://www.scu.edu.au/changeofnamehttp://www.scu.edu.au/changeofnamehttp://www.scu.edu.au/englishskills7/29/2019 Le Cordon Bleu Master of Gastronomic Tourism Direct Application Form (v20130305)
3/4Le Cordon Bleu Australia CRICOS Provider: SA 01818E, NSW 02 380M | Southern Cross University CRICOS Provider: NSW 0124 1G, Qld 03135E | This course is not available to international students studying in Australia
7. QuAliFiCAtions SCU has the right to request documentation to support your application at any time.
All information entered must be true and accurate.
X Please see ront page note regarding supporting documentation required.X All Post Secondary Studies indicated below must be six months ull time equivalent or more.
Post Secondary Studies: Include Tertiary PreparationCoursesand all Cert IV or higher. Only include Cert III i this was part o gaining a trade qualiication/licence
1 2 3
Last year enrolled:
(e.g. 2001)Name o Course:
Student ID:
(i known)
Institution:(including country i not Australia)
Is qualifcation complete?
YES NO
YES NO
YES NO
Passed (e.g. 8 units):
Passed (e.g. 8 units):
Passed (e.g. 8 units):
Failed (e.g. 6 units): Failed (e.g. 6 units): Failed (e.g. 6 units):
I qualifcation notcomplete, please indicate
the number o units:Currently enrolled or waiting
or results: (e.g. 2 units)Currently enrolled or waiting
or results: (e.g. 2 units)Currently enrolled or waiting
or results: (e.g. 2 units)Have you been excluded fromstudy due to academic failure
within the last 12 months?YES NO
YES NO
YES NO
Have you ever been expelled?*(e.g. not allowed to return)
YES* NO
YES* NO
YES* NO
* I Yes, attach a letter giving details o the expulsion
Is this an overseas qualifcation?*
YES NO
YES NO
YES NO
* I you hold qualications rom overseas or you are not an Australian citizen please reer toscu.edu.au/englishskills as you may need to provide evidence o English language prociency.
8. seConDAry stuDies
SECONDARY STUDIES:(Year 12 or equivalent)Year completed: State: (or Country if overseas) Name of School/College attended: ATAR, UAI, OP, ENTER, TE R or equivalent score:
9. employment experienCe
Employment experience may be continuous with one employer or periodso similar work with dierent employers, and does not have to be relevantto the proposed course o study. Attach additional pages i required.
Only periods o paid employment o one year ull-time equivalent (FTE) ormore will be considered. e.g. 20 hours per week for two years = 1 yearfull-time equivalent. Attach additional pages i required.
1 2 3
Position title:(e.g. Payroll Clerk)
Name o Employer:(e.g. ABC Warehouse)
Years o service ull-time
equivalent (FTE):
List three (3) major tasksperormed in this occupation:
(e.g. receive invoices and arrangepayments, supervise three staf)
hLP: Assess/DAte:
RAnK: Boo/Com CoDe:
BoA: sCALe: oFFiCeuse
http://www.scu.edu.au/englishskillshttp://www.scu.edu.au/englishskills7/29/2019 Le Cordon Bleu Master of Gastronomic Tourism Direct Application Form (v20130305)
4/4Le Cordon Bleu Australia CRICOS Provider: SA 01818E, NSW 02 380M | Southern Cross University CRICOS Provider: NSW 0124 1G, Qld 03135E | This course is not available to international students studying in Australia
Parent/guardian 1
Male Female No parent/guardian
What is the highest level o education completed by your parent/guardian 1?
(tick one):
Didnt complete Year 10 schooling(includes completed primary schooling only or did not go to school)
Completed Year 10 schooling*
Completed Year 10 schooling*, continued at school,but didnt complete Year 12 schooling*
Completed Year 12 schooling*
Other post-school qualication (e.g. associate degree, diploma, advanceddiploma, completed apprenticeship, VET/TAFE certicate)
Bachelor degree
Postgraduate qualication(e.g. graduate diploma, masters degree, PhD)
Dont know *or equivalent
Parent/guardian 2
Male Female No parent/guardian
What is the highest level o education completed by your parent/guardian 1?
(tick one):
Didnt complete Year 10 schooling(includes completed primary schooling only or did not go to school)
Completed Year 10 schooling*
Completed Year 10 schooling*, continued at school,but didnt complete Year 12 schooling*
Completed Year 12 schooling*
Other post-school qualication (e.g. associate degree, diploma, advanceddiploma, completed apprenticeship, VET/TAFE certicate)
Bachelor degree
Postgraduate qualication(e.g. graduate diploma, masters degree, PhD)
Dont know *or equivalent
Checklis
t Have you completed all your personal, contact and course
inormation? Have you entered details o your qualications?
Have you supplied an original or certied copy o academictranscripts?
Have you supplied an original or certied copy o IELTS testresults
Have you supplied documentary evidence and ocial
translations or overseas qualications? Have you signed the Declaration?
Applying or credit or prior study? Please seescu.edu.au/advancedstandingor an application ormand/or urther inormation.
Privacy notice
Southern Cross University (SCU) and Le Cordon Bleu Australia (LCBA) are
requesting the inormation in this orm so that we can process your application
or admission. In processing your application, SCU and/or LCBA may need to:
y obtain urther inormation about your application rom other organisations,
such as by means o an electronic qualication verication search like
QualSearch, and
y disclose inormation about you to the Australian Taxation Oce, Centrelink,
the Department o Education, Employment and Workplace Relations
(DEEWR), other relevant Australian government agencies and to UAC and/
or QTAC.
SCU and LCBA will not disclose your personal inormation to anybody else
outside SCU or LCBA, without your consent, unless SCU and/or LCBA are required
to do so by law or example i the inormation is needed in an emergency or
or law enorcement purposes.
Providing us with the inormation in this orm is not required by law. However
i you choose not to provide us with the requested inormation, we cannot
process your application or admission. I you progress to enrolment andbecome an SCU student, SCU and LCBA will collect urther personal inormation
rom you, to use and disclose or other purposes.
To access or update your personal inormation, to contact the SCU Privacy
Contact Ocer, or or more inormation about SCU privacy obligations and
privacy practices, see scu.edu.au/privacy. For LCBA privacy practices, see
lecordonbleu.com.au/privacy/.
Applicant declaration and agreement
I declare that I have read this application orm and the conditions specied
in it and agree that I accept those conditions; and that all inormation and
documents provided with this application orm are complete and accurate.
I acknowledge that it is my responsibility to ensure that I supply complete
and accurate inormation and documents in connection with this application;
and that SCU and LCBA may withdraw any ofer or cancel my enrolment i any
inormation or documents submitted with this application are incorrect or
incomplete.
I authorise SCU and LCBA to obtain any urther inormation about this
application rom other organisations, such as by means o an electronic
qualication verication search like QualSearch; and to disclose inormation
about me to DEEWR, Centrelink, UAC and/or QTAC as relevant. I also authorise
other organisations to supply inormation to SCU and/or LCBA in order to veriy
any inormation I have provided in this application.
I agree that SCU and/or LCBA may withdraw any ofer made to me on orbeore the lapse date, even i I have already accepted that ofer; and that I am
bound by and to comply with SCUs, rules, policies, By-laws, codes o conduct
and procedures in orce rom time to time; and that SCU and LCBA may send
inormation to me electronically.
11. AppliCAnt DeClArAtion
Print Name
Signature Date
10. eDuCAtion level oF your pArents or guArDiAns
These questions are about the highest level o education completed by your parents or guardians, a requirement o the Australian Government Department o Employment,
Education and Workplace Relations. It will not be used by Southern Cross University in the assessment o your application or admission.
Please answer about the people (up to two) who, during all (or most ) o your school years, were your parents or guardians. I you have more than two, answer about those
you have spent the most time with.
Important: Please read the following carefully before you sign the declaration below.Your application will not be considered unless you sign this declaration.
http://www.scu.edu.au/advancedstandinghttp://www.scu.edu.au/advancedstandinghttp://www.scu.edu.au/privacyhttp://www.lecordonbleu.com.au/privacy/http://www.lecordonbleu.com.au/privacy/http://www.scu.edu.au/privacyhttp://www.scu.edu.au/advancedstanding