Membership Application

required required Fields marked with a * are required.

Name of Institution *

First Name of Principle Executive Officer *

Last Name of Principle Executive Officer *

Postal Address *

Postal Address 2

City *

State * State *Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia

Postcode *

Country *

Telephone *

Email *

Business Address

Business Address 2

City

State StateAustralian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia

Postcode

ABN Number *

Courses Offered Courses Offered Please email a separate document with the course code and full name of each course and the expected student numbers to office@wapetia.org.au

Registration Details Registration Details Please provide documentary evidence of current registered courses.

Registration Authority

Date Granted

Expiry Date

Approved for Overseas Students * Approved for Overseas Students *YesNo

Student capacity number for international students (if known)

Documenation - Please email the following documents to office@wapetia.org.au Documenation - Please email the following documents to office@wapetia.org.au ASIC Company Registration Accreditation Documents (ie NEAS, TAC) List of all delivery locations in WA The School/College's management and organisational structure If already registered: CRICOS Individual Provider Report with Registered Courses - downloaded from PRISMS If already registered: COE Statistics Report for Active CoEs - downloaded from PRISMS

Nomination Details Nomination Details Nomination Details - An application for WAPETIA membership must be supported by two current WAPETIA member representatives, neither of which can have common directorship or financial affiliation with the applicant institution.

Name of Supporter *

Intitution *

Name of Supporter *

Intitution *

Payment of Fees Payment of Fees Payment of Fees Current Annual Membership Fee $2000.00 If the application is received after January, the annual membership will be calculated on a monthly pro-rata basis. Application Fee $3000.00 The application fee is non-refundable if the application is accepted. The application fee will be returned if the applicant is not successful. The applicant School/College agrees to be bound by the Constitution of the Western Australian Private Education and Training Association Inc. and to comply with its rules, regulations and Code of Ethics. The applicant School/College hereby gives consent for WAPETIA to validate the information provided on this form. The applicant School/College agrees to comply with the Education Services for Overseas Students Act 2000 (ESOS) and the National Code 2007. This application is accepted by WAPETIA in consideration of the above, and in further consideration of the applicant School/College releasing and holding safe WAPETIA from any and all liability for the consequences, financial or of any other sort, of this application or membership of WAPETIA.

Confirmation Confirmation By submitting this application I confirm, that all information provided is correct and that I will forward my payment of the application fee by mail to WAPETIA PO Box 6 North Perth WA 6006