UNSW Learning Abroad | Short Term Application Form

OVERSEAS PROGRAM NAME

(NOTE: Students are not eligible to receive academic credit for a
Learning Abroad Short Program in their home country)

PERSONAL DETAILS

Student ID

First Name

Preferred First Name

Last Name

UNSW Email

Phone

Date of Birth

Country of Nationality

Country of Nationality (Secondary). Leave blank if you are not a dual citizen.

Do you have a long-term health and mental health condition, or living with a disability? This question will give us an idea of any extra educational adjustments and accessibility support you may require at the university.

If you would like to specify or discuss with an advisor what support you may need, please email us at advisor4globaled@unsw.edu.au

ACADEMIC DETAILS

UNSW Program (Code and Name)

Weighted Average Mark (WAM)

OVERSEAS PROGRAM DETAILS

Proposed Program Start Date

Proposed Program End Date

TRANSFER OF CREDIT

Which course/s would you like to take in this short program? Please enter the host university course codes or the name of the program.

MOTIVATION

QUESTION
What are your motivations for attending this program and what do you hope to achieve? (300 words maximum)

Would you like to be considered for a Learning Abroad Travel Grant? If so, please write a justification on how you will be an ambassador for UNSW while undertaking the program (max. 100 words)

DECLARATION AND CONSENT

I declare, acknowledge, and agree that:

Program Participation

I am participating in a UNSW Learning Abroad Short Program (for credit, co-curricular, or extra-curricular purposes) and must act as a positive ambassador for UNSW at all times.
I must comply with the UNSW Student Code of Conduct, including while overseas or participating in online program activities.
I have read and agree to the UNSW Learning Abroad Short Programs Terms and Conditions.

Privacy and Information Sharing

I consent to UNSW disclosing my personal information to International SOS, UNSW’s contracted emergency and medical assistance provider.
I consent to UNSW disclosing my personal information to the Department of Foreign Affairs (as defined in the Privacy Act 1988 (Cth)). I confirm that I am aware that if the Department of Foreign Affairs and Trade discloses my personal information to an overseas recipient then: the overseas recipient may not be bound by Australian privacy legislation and/or be subject to any privacy obligations; the Department of Foreign Affairs and Trade will not be accountable under the Privacy Act should the overseas recipient breach Australian Privacy Principles; Australian Privacy Principle 8.1 will not apply to the disclosure of the information.
I consent to UNSW disclosing my contact information to media representatives for purposes of promoting UNSW in promotional material, information and publications in hardcopy and/or on the internet.

Travel Approval and Compliance

I acknowledge and agree that I will complete all compulsory pre-departure briefing and e-learning modules at Preparing for your time abroad Tutorial, before travel
I acknowledge that UNSW will assess my eligibility and provide a decision on my approval to travel.
I acknowledge that if I am not approved to travel, I will be withdrawn from the program.
I acknowledge that if my travel is approved, I will register with International SOS for the duration of my overseas program.
I acknowledge that if my travel is approved, I will purchase a return ticket prior to departure.
I acknowledge that UNSW may deny or withdraw my travel approval if my destination is assessed as high risk.
I understand and acknowledge that I may not be covered by UNSW insurance if:
- My travel is not approved; or
- DFAT travel advice for my destination is raised to Level 3 or Level 4.
I acknowledge and agree that I will take appropriate precautions to protect my health, safety and wellbeing while participating in the program.

Travel Risk Awareness and Preparation

I agree to read and follow advice from Smartraveller and International SOS for all destinations I will be visiting.
I agree to download and use the International SOS Assistance App while abroad.
I agree to monitor travel warnings and updates for all locations I visit.
I agree to ensure that I have appropriate and sufficient travel insurance, where UNSW insurance does not provide adequate coverage for my circumstances.
I agree to arrange a medical check-up, including required vaccinations and ensuring any medications I carry are legal in my destination(s).

Submit