Application for Admission to Graduate Research Degree Candidature and Scholarship

Application for Admission to Graduate Research Degree Candidature and Scholarship Application for Admission to Graduate Research Degree Candidature and Scholarship Who should use this form? This application form should only be used by those applying to undertake graduate research degrees (also known as Research Higher Degrees) including: Doctor of Philosophy (PhD) Master of Philosophy (MPhil) Doctor by Research Masters by Research For a list of all degrees please visit the University of Melbourne Course Directory and search the Graduate Study section by Type/Research (http://coursesearch.unimelb.edu.au). Important things to know before you submit your application: 1. Please ensure that your application is complete and includes all supporting documentation. On average it takes 6-8 weeks to process a complete application for graduate research degree candidature although some Faculties and Graduate Schools have shorter or longer timeframes. Notification of scholarship outcomes may take longer depending on when you apply and the scholarships for which you are being considered. Please note that submitting an incomplete application will cause significant delays and may prevent your application from being processed. 2. It is ESSENTIAL to make contact with your prospective Faculty/Graduate School and/or academic department prior to submitting a formal application and you must follow their unique pre-application procedures. Each Faculty/Graduate School has its own processes, supporting documentation and course entry requirements so you should ensure that you understand and follow the ones that apply to you. Most require that you contact your potential supervisor(s) at the University of Melbourne and secure their support prior to submitting an application. Failure to do this if required will result in a delay in assessing your application. Links to Faculty/Graduate School websites are available at http://go.unimelb.edu.au/9kj. 3. Original documents will NOT be returned to you. Please provide certified copies of any official documents if you need to keep the originals. A certified copy is a photocopy of an original document with the signature and official stamp of an appropriate authority (eg Justice of the Peace, barrister or solicitor, principal of school, doctor, dentist, pharmacist, veterinary practitioner, police officer, notary, clerk of court, or an official records officer from the institution that issued the original document) indicating that they have sighted the original. A photocopy of a certified copy is not acceptable. Documents in languages other than English must be accompanied by an English translation that has been certified as an accurate translation. 4. Please take the time to read through this form before you begin to complete it. Lodging Applications It is important to consider scholarship application deadlines when preparing your graduate research degree application. Many Faculties and Graduate Schools will assess applications for admission at any time, but there is only one application round for the major scholarships. Please visit the Melbourne Scholarships Office page for details of all scholarship deadlines: http://go.unimelb.edu.au/3kj. Please mail or deliver in person your complete application together with all supporting documentation to: Graduate Research Degree Admissions Information Centre, Richard Berry Bldg, Gate 3, Swanston Street, Parkville, Victoria 3010, Australia An email confirmation will be sent within 5 business days after we receive your application. For inquiries related to submitting your application please contact rhd-admissions@unimelb.edu.au. Please add this email address to your safe senders list. CRICOS Provider Number: 00116K Page 1 of 15

International Applicant Assessment Fee An application assessment fee is payable by all international applicants except in cases where applicants are eligible for assessment fee waivers. For information on who is eligible for exemptions and how to apply please visit http://go.unimelb.edu.au/n3j. Once you enrol at the University of Melbourne, the assessment fee is deducted from your tuition fees or refunded to you. PAY BY CREDIT CARD Please charge AUD$100 to my credit card below Card type Mastercard Visa Card number Card expiry date (mm/yyyy) Cardholder name (please print) Cardholder signature PAY BY BANK CHEQUE Note: The bank cheque must be payable to an Australian bank. I attach a bank cheque or money order for AUD$100 made payable to the University of Melbourne. CRICOS Provider Number: 00116K Page 2 of 15

FOR INTERNAL USE ONLY Date received Applicant name Applicant ID Applicant type Local International Department Graduate Research Degree and/or Scholarship Application Please type or write clearly in BLOCK LETTERS using a black pen. Mark with an X all boxes that are applicable. I wish to apply for: Admission to Graduate Research Degree Candidature and Scholarship Admission to Graduate Research Degree Candidature only Please note: University of Melbourne graduate researchers who wish to apply for a scholarship for the course in which they are currently enrolled should apply online via the Student Portal: portal.unimelb.edu.au. I am a: New applicant Previous applicant Currently enrolled University of Melbourne student Date of previous application Student ID Email address Former University of Melbourne student Student ID A. PERSONAL DETAILS If you are a new or previous applicant, or a former University of Melbourne student, please complete all sections. If you are a currently enrolled University of Melbourne student, please ensure that you have provided your Student ID and email above, use the Student Portal to ensure that your personal details are current, fill in only your name(s) and date of birth in Section A, and then complete sections B-G of this form as appropriate. Title Ms Mrs Miss Mr Other, please specify: Family Name Preferred Name Given Names Previous Names Date of Birth (dd/mm/yyyy) Gender F M Current Mailing Address Street Address Suburb State or Province Country Postcode CRICOS Provider Number: 00116K Page 3 of 15

A. PERSONAL DETAILS (continued) Permanent Address (if different from mailing address. At least one must be a residential address) Street Address Suburb State or Province Country Postcode Telephone (including country codes) Home Work Mobile Email (please provide an address that will be active for at least six months) Birth, Citizenship and Residency Status Please attach a certified copy of your birth certificate, certificate of citizenship or passport. My country of birth is: I am a citizen of: Australia New Zealand Other. Please specify all countries for which you are a citizen: Do you currently hold an Australian visa? No / Not applicable Yes, I hold a permanent residency or humanitarian visa (please provide evidence of permanent resident status or copies of passport visa pages) Yes, I hold a temporary visa Subclass Subclass I am an Australian citizen or permanent resident AND am of (mark all that apply): The primary language I speak at home is: Aboriginal origin Neither Torres Straight Islander origin B. CANDIDATURE DETAILS Application Details I am applying as a: Local applicant (citizens of Australia, New Zealand or Australian permanent residents only) International applicant (citizens of all other countries and holders of Australian visas other than permanent residency) I am applying for the following degree program (choose ONE only): Master of Philosophy (MPhil) Doctor of Philosophy (PhD) Masters (please specify): Other Research Doctorate (please specify): CRICOS Provider Number: 00116K Page 4 of 15

I am applying to undertake a: Joint PhD or Cotutelle degree or Other Special PhD Program at the University of Melbourne and the following university outside Australia: in the following city or country: Note: For information, policy and procedures on these unique PhD programs, please visit: http://www.gradresearch.unimelb.edu.au/future/jointphd.html I am applying for admission to the following Faculty/Graduate School: Architecture, Building and Planning Arts Business and Economics Education Engineering Land and Environment Law Medicine, Dentistry and Health Sciences Melbourne Business School Science Veterinary Science VCA and Music And the following school and/or department: (where relevant please specify): I plan to spend 40 or more of my time at an external institution during the course of my research (eg the CSIRO, Peter MacCallum Cancer Centre, etc.). Please specify: I have contacted the following preferred supervisor(s). Please provide name(s) and the school/department of your preferred supervisor(s): Not all degree programs require that you identify and make contact with a preferred supervisor before you apply, but most do. Please visit your prospective Faculty/Graduate School s How to Apply website for details on the requirements that apply to you. http://go.unimelb.edu.au/9kj. My proposed thesis title/topic is: Virtually all programs require you to provide a 100-word summary of your proposed research project in the required CV (resume) attached to this application. Your prospective Faculty/Graduate School may also require an additional research proposal. Please visit your Faculty/Graduate School How to Apply website for detailed information on what is required (including required word count). For information on the layout of your CV please see the Guide to Formatting Your CV found here http://go.unimelb.edu.au/t7j. I have read and understood the information contained in the document Intellectual Property Rights and Responsibilities: Information for Prospective Research Students available at http://go.unimelb.edu.au/t7j. I would like to begin my candidature on: (Please indicate your proposed commencement date or commencement semester and year) Proposed commencement date: (dd/mm/yyyy) Semester 1 in the year 20 Semester 2 in the year 20 (begins in February) (begins in July) CRICOS Provider Number: 00116K Page 5 of 15

Study Status I plan to study: Full-time Part-time > Please specify why part-time: eg work commitments, carer status Please note that: Part-time study is NOT an option for those international applicants on a student visa in accordance with Australian Department of Immigration and Citizenship regulations. Scholarships may only be held on a part-time basis if socially compelling reasons preclude a full-time enrolment. Please see the information on holding a research degree scholarship part-time at http://go.unimelb.edu.au/w9j. Residency Please note that in most cases a significant amount of your candidature must be spent in advanced study and research at the University of Melbourne. For information on residency requirements and how to apply for special residency status, please visit the following degree specific websites: PhD and Research Doctorates - standard residency requirement of at least 12 months full-time (24 months parttime) of candidature: http://go.unimelb.edu.au/c9j. MPhil - standard residency requirement of the equivalent of at least six months full-time (12 months part-time) of candidature: http://go.unimelb.edu.au/79j. Master by Research - standard requirement of residence in Victoria for at least one-third of candidature: http://go.unimelb.edu.au/g9j. For Scholarships residency requirements: http://go.unimelb.edu.au/99j. I am able to meet the residency requirement that applies to the graduate research degree for which I am seeking admission: Yes No > If No, you must submit with this application a one-page maximum special residency status request as outlined on the relevant website above. This request will be reviewed by your prospective supervisor, school, department and/or Faculty and must be endorsed by them before it can be approved by the University. Sponsorship Arrangements I will be sponsored by a company, home government or scholarship body that will provide a stipend, tuition fees, travel allowance, health insurance and/or other form of financial support during my candidature. Yes No Please provide details of any sponsorship arrangements, scholarships or research grants currently held or awarded. If you have applied or plan to apply for external support please provide that information as well: Please attach evidence of awarded sponsorships, scholarships, or research grants, including details of funding body and duration to this application. CRICOS Provider Number: 00116K Page 6 of 15

C. ACADEMIC QUALIFICATIONS Application Details Please list below ALL tertiary level studies you have undertaken including those in which you are currently enrolled (whether you have completed them or not) beginning with the most recent. You must also provide this information in the required CV (resume) attached to this application. Please see the Guide to Formatting Your CV provided at http://go.unimelb.edu.au/t7j. Please note the following documentation requirements: Applicants must provide an original or certified copy of their full official transcript(s) on official university stationery which contains that university s logo, indicating all subjects and results in all years of study for each qualification completed or attempted, along with an explanation of that university s grading system. Applicants are advised that documents other than an original or certified copy of their full official transcript, including faxed documents, emailed documents or documents obtained via the internet will not be accepted. You are not required to provide transcripts for study previously completed or currently being undertaken at the University of Melbourne. If you have completed a degree but your transcript does not specifically state this fact, you must provide an original or certified copy of an official letter from your institution confirming completion, in addition to your final academic transcript. If you are currently enrolled in a tertiary course at any institution other than the University of Melbourne, please provide a transcript that shows your results to date and provide updated transcripts as soon as they become available. If you have received credit toward your degree at the 3 rd year level or higher, please include the transcript/s for the studies for which you have received credit. For example, if you received 3 rd year credit toward a University of Melbourne qualification for subjects completed on exchange at the University of London, please also submit your University of London transcript. Any documents that are not in English must be accompanied by a certified English translation. If your current name is not the same as the name on your transcripts (eg due to marriage) please provide a certified copy of the document which indicates a legal change in name (eg a marriage certificate). Official advice from your current or previous university detailing the actual numeric marks (eg 82) or Grade Point Averages (eg 3.4) you achieved for your tertiary studies. Applicants with a Masters qualification should provide examiners reports if they are available and an extract from the relevant university handbook (or website) that clearly states (i) the normal duration of the Masters course (eg 2 years full-time) and (ii) the structure of the course (eg minimum of 24 points, of which 18 points are a research project). You must provide information about the amount of research required for the qualification. Applicants who have completed a MBBS, BPhysio, BDSc or BDS, LLB, BVSc or BMVS are advised to provide information about their 'position on their graduating class list' if available. If this information is not available on the transcript, advice should be provided in writing from the relevant faculty, school or department. Tertiary Qualifications Provide details of your most recent tertiary studies below beginning with the current or most recent course of study. Remember to provide a summary of ALL tertiary studies that you have undertaken in your CV. Name of Degree Name of Institution and Country Research (If applicable) Program Length (eg. 3years) Date Completed (mm/yy) Grade (Overall Degree Grade Point Average) CRICOS Provider Number: 00116K Page 7 of 15

Tertiary Qualifications (continued) Name of Degree Name of Institution and Country Research (If applicable) Program Length (eg. 3years) Date Completed (mm/yy) Grade (Overall Degree Grade Point Average) If you are currently completing a degree, please write CU in the Date Completed column for current and include the date that you anticipate completion by month and year. If you began a degree and did not complete it, please write INC for incomplete. Current Enrolments I am currently enrolled in a graduate research degree program at another Australian university and wish to transfer to the University of Melbourne to complete this course. (Please provide the following information) Name of degree and academic program: Name of institution: Commencement date: (dd/mm/yyyy) Last date of enrolment: (dd/mm/yyyy) Start and end dates for any and all leaves of absence from your studies: Enrolment status at commencement: (ie full-time or part-time) Percentage research: Start and end dates for any variations to your enrolment status: (eg Full-time 15/02/2008-31/08/2008, Part-time 01/09/2008-04/06/2008) Please note that any prior period of graduate research degree candidature in Australia may be deducted from the maximum period of candidature in the degree for which you are applying as well as from the maximum scholarship period. You must include an official statement from your previous Australian university (or universities if you were enrolled at more than one) which includes details of your enrolment periods, full-time or part-time status, any scholarships received and total consumed Equivalent Full-Time Student Load (EFTSL). CRICOS Provider Number: 00116K Page 8 of 15

D. RESEARCH AND/OR RELEVANT PROFESSIONAL EXPERIENCE (Last 5 Years) Research Project / Thesis I completed a significant research project (eg a thesis) during my fourth year or higher tertiary studies. Please describe: If examiners reports are available please attach copies. Relevant Professional Experience I have research and/or professional experience gained via employment that is relevant to my proposed project/graduate research degree program. Please provide the following information. Organisation name: Start and end dates: Average hours per week: Please include in your required CV (resume) a brief description of your role and the relevant research and/or professional experience gained for each professional role you have held. Please note that you must also arrange for an Employer Referee Report Form to be submitted for each role you list in your application. The form is available from http://go.unimelb.edu.au/t7j. Medical Fellowships I have held or currently hold a medical fellowship or have completed the first three years of clinical fellowship training indicated by success in passing the specified Written and Clinical Examinations. Please provide the following information: Name of fellowship: Date awarded: (mm/yyyy) Official website: that provides details of the fellowship (eg general description, criteria for award) Please include this information in your required CV (resume) and attach a photocopy of the certificate recognising the award of this fellowship or a letter from the fellowship organisation or a copy of the letter issued by the training regulator (eg the Royal Australasian College of Physicians, Royal Australasian College of Surgeons or equivalent). Information on Relevant Publications and Creative Works I have publications (journal articles, refereed conference papers, book chapters, books, etc) accepted or already published. Please include a bibliographic summary of all relevant peer-reviewed presentations and publications in your required CV (resume). For information on how to format this bibliography correctly, please refer to the Guide to Formatting Your CV instructions available here http://go.unimelb.edu.au/t7j. For print publications you must also provide a photocopy of the first page of the paper/chapter/book and a copy of the front page of the journal/book in which it appeared. If the publication is electronic only or difficult to photocopy, provide the DOI (Digital Object Identifier). If the work is still in press, please provide proof of acceptance from the editor/publisher. For conference papers, please provide evidence of peer-review such as a photocopy of the conference proceedings / program which states the review policy or a copy of the reviews. CRICOS Provider Number: 00116K Page 9 of 15

I have produced creative works (eg visual arts, music, theatre, dance, film, creative writing, environmental design etc) that are eligible as research outputs. If marked, please include citations for all relevant creative works in your required CV (resume). For information on how to format citations, please see the Guide to Formatting Your CV at http://go.unimelb.edu.au/t7j. You must also attach the required evidence as outlined in the Eligible Research Output Types: Creative Works table available from http://go.unimelb.edu.au/t7j. Please do not submit actual portfolios, musical scores, CDs, DVDs, etc with this application. Where these materials are required, your prospective Faculty or Graduate School s How to Apply website will provide information on how to submit these types of material. E. ENGLISH LANGUAGE PROFICIENCY (All Applicants) Please refer to the Future Students website for the latest information on the University s English language requirements including approved final-year subjects and required Academic IELTS and TOEFL scores: http://go.unimelb.edu.au/57j. Please provide documentary evidence for the items marked I have satisfied the English language requirements for admission to the University via the following means (only one is necessary): Satisfactorily completed secondary studies and gained the required score in an approved final-year English subject as per the list of approved subjects found at http://go.unimelb.edu.au/57j. Please specify approved subject: Within the last 2 years satisfactorily completed either a postgraduate degree of at least two years duration or an undergraduate degree, where the degree was taught and assessed entirely in English. (Note: If the degree was completed within the last 5 years, you may provide evidence of sustained working in an English language environment and/or writing in English since completing the degree.) Within the last 2 years satisfactorily completed a postgraduate degree of at least one year duration, where the degree was taught and assessed entirely in English and the English language entry standard was at least IELTS (Academic) overall band score 6.5 or equivalent. (Note: If the degree was completed within the last 5 years you may provide evidence of sustained working in an English language environment and/or writing in English since completing the degree.) Undertaken the American Test of English as a Foreign Language (TOEFL), including the Test of Written English (or the essay writing component in computer-based testing) in the 24 months preceding application and obtained scores as prescribed by my prospective Faculty/Graduate School. Undertaken the Academic International English Language Testing System (IELTS) in the 24 months preceding application and obtained scores as prescribed by my prospective Faculty/Graduate School. CRICOS Provider Number: 00116K Page 10 of 15

F. SCHOLARSHIP DETAILS Scholarship categories are primarily based on whether you are a local or international applicant. Information regarding graduate research scholarships for each category is available from the Melbourne Scholarships Office (MSO) website below. Local applicants please visit http://go.unimelb.edu.au/k9j International applicants please visit http://go.unimelb.edu.au/39j I have read and understood the scholarship criteria and eligibility requirements that apply to me. DEADLINES: To be considered for scholarships, complete application materials must be postmarked or hand delivered to the address at the beginning of this application no later than the dates outlined: For local applicants: http://go.unimelb.edu.au/q9j For international applicants: http://go.unimelb.edu.au/z9j I am a local applicant and would like to be considered for the following scholarships: Australian Postgraduate Award (APA) Melbourne Research Scholarship (MRS) Human Rights Scholarship (HRS) Frederick Blake Shepherd Scholarship Harbison-Higinbotham Research Scholarship Sir John and Lady Higgins Research Scholarship Baillieu Research Scholarship Ernst & Grace Matthaei Research Scholarship Faculty/Graduate School Scholarships Fay Marles Scholarship (FMS) Scholarships marked with a above require that additional application materials be attached to this form. For eligibility please visit http://go.unimelb.edu.au/6kj and http://go.unimelb.edu.au/8kj for documentation requirements. Refer to your Faculty/Graduate School website for information on these Scholarships. If you wish to apply for a Fay Marles Scholarship, please visit http://go.unimelb.edu.au/2qx for eligibility and specific documentation requirements. I am an international applicant and would like to be considered for the following scholarships: International Postgraduate Research Scholarship (IPRS) Melbourne International Fee Remission Scholarship (MIFRS) Melbourne International Research Scholarship (MIRS) Human Rights Scholarships (HRS) Faculty Scholarships Scholarships marked with a above require that additional application materials be attached to this form. For eligibility and documentation requirements please visit: http://go.unimelb.edu.au/o7j. Refer to your Faculty/Graduate School website for information on these Scholarships. My current residence (if not the same as my current mailing address above) is located in: Victoria Australian Capital Territory New South Wales Other (please specify): Northern Territory Queensland South Australia Tasmania Western Australia CRICOS Provider Number: 00116K Page 11 of 15

I expect to live in the Melbourne area while receiving a scholarship: Yes No > If no, where do you intend to live? I have received or currently hold a graduate award or scholarship. If yes, please provide the following details: Name of award Institution by which the award was granted Award s annual monetary value Award start and end dates Briefly describe the research or study the award is supporting: Please do not include HECS exemptions. If you have received more than one scholarship or award, please include the above information for each of them in your required CV (resume) and write above please see my CV. G. ACADEMIC REFEREES Applicants must provide academic references according to the following: If your last tertiary qualification was completed outside Australia you must provide two written academic referee reports. If your last tertiary qualification was completed at an Australian university other than the University of Melbourne you must provide one written academic referee report. If your most recent qualification was obtained from, or you are currently enrolled at the University of Melbourne you do not need to submit any written academic references. All academic references must be completed using the Academic Referee Report Form available from http://go.unimelb.edu.au/t7j. All applicants, including those currently enrolled at the University of Melbourne, must provide below the names and contact information of two academic referees. For those applicants whose most recent qualification was earned at an institution other than the University of Melbourne, these should be the name(s) of the referees you have asked to complete the Academic Referee Report Form. If you have not been enrolled in a tertiary course for more than 5 years but have been working in an area related to the discipline for which you have applied, you can provide the names of referees who are familiar with your work and arrange for an Employer Referee Report to be completed. It is available from: http://go.unimelb.edu.au/t7j. Referee One Full name and title Name of University of Melbourne department / school / faculty (if applicable) Name of external university/organisation (if applicable) Academic position Relationship to applicant Email Phone (Business Hours) include country code Fax (Business Hours) include country code CRICOS Provider Number: 00116K Page 12 of 15

Referee Two Full name and title Name of University of Melbourne department / school / faculty (if applicable) Name of external university/organisation (if applicable) Academic position Relationship to applicant Email Phone (Business Hours) include country code Fax (Business Hours) include country code Appointment of Agent (International applicants only) I have appointed a University of Melbourne authorised agent to manage my application. Please provide: Name of agency City Country You will find the agent details from the list of authorised agents available from: http://go.unimelb.edu.au/2kj. APPLICATION DECLARATION AND SIGNATURE 1. I declare that the information I have submitted with this application is a true and complete record of all academic results I have achieved at each and every university and tertiary institution which I have attended. 2. I hereby authorise the University of Melbourne to make enquiries and to obtain official records from any university and tertiary educational institution concerning my current or previous attendance which, in its absolute discretion, it believes are necessary. 3. I acknowledge that my failure to disclose my true and complete tertiary record may result in my being excluded from the University. I further declare that all the financial information supplied by me is complete, true and correct in every particular and acknowledge that the University may terminate my studies if I have misrepresented my past and/or present circumstances and that this termination may take place at any stage during the course undertaken. 4. I understand that should I be awarded a scholarship from the University of Melbourne I may not hold another equivalent award at the same time. 5. I declare that I will be able to abide by the University s policy regarding refunds outlined in Arrangements Relating to the Payment of Student Fees. 6. I understand that should I be awarded a scholarship from the University of Melbourne, I will be required to repay to the University of Melbourne any scholarship/s that I have received on the basis of false or misleading information included in my application. Scholarship benefits may include living allowances, fee remission and travel allowances. 7. I understand that the personal information that I have provided may be released to Australian Commonwealth and State agencies under the Education Services for Overseas Students (ESOS) Act 2000. 8. I understand that the University reserves the right to inform other tertiary institutions if any of the material presented to support my application is found to be false. 9. I acknowledge that all documents submitted become the property of the University of Melbourne. 10. I have read and understood the University of Melbourne Standard Privacy Statement for Student Related Forms/Publications and Websites located at http://go.unimelb.edu.au/59j. CRICOS Provider Number: 00116K Page 13 of 15

APPLICATION DECLARATION AND SIGNATURE (continued) Name of applicant (please print) Signature of applicant Date (dd/mm/yyyy) CHECKLIST OF SUPPORTING DOCUMENTATION Please ensure that your application is complete and includes all supporting documentation. On average it takes 6-8 weeks to process a complete application for graduate research degree candidature although some Faculties and Graduate Schools have shorter or longer timeframes. Notification of scholarship outcomes may take longer depending on when you apply and the scholarships for which you are being considered. Please note that submitting an incomplete application will cause significant delays and may prevent your application from being processed. Please provide certified copies of any original documents that you need to keep as no part of your application will be returned to you. Once your application has been submitted and the Graduate Research Degree Admissions Office has acknowledged receipt, you should direct all questions to your prospective Faculty/Graduate School or academic department contacts. Additional forms and guides may be found at: http://go.unimelb.edu.au/t7j. A certified copy is a photocopy of an original document with the signature and official stamp of an appropriate authority (eg Justice of the Peace, barrister or solicitor, principal of school, doctor, dentist, pharmacist, police officer, notary, clerk of court, or an official records officer from the institution that issued the original document) indicating that they have sighted the original. A photocopy or fax of a certified copy is not acceptable. Documents in languages other than English must be accompanied by an English translation that has been certified as an accurate translation. Compulsory Documentation for ALL Applicants I have included in my application the following materials: A completed application form. A certified copy of my birth certificate, certificate of citizenship or passport. A curriculum vitae (CV/resume) that follows the formatting and content requirements indicated in the Guide to Formatting Your CV and in the directions contained in this application form. Additional Documentation (as applicable) I have also included the following supplementary materials: Evidence of Australian permanent residency if applicable. Original or certified copies of your transcripts for every tertiary program of study undertaken along with an explanation of each institution s grading system. Certified copies must include both sides of the transcripts. If you are currently enrolled in a tertiary course other than the University of Melbourne, please provide a transcript that shows your results to date. This documentation is required of ALL applicants with the exception of currently enrolled University of Melbourne students who have never studied at another tertiary institution. Transcripts are not required for qualifications completed at the University of Melbourne. Request for special residency status (see information and links in Section B above) An extract from the official university handbook or website from which I earned a Masters degree that clearly states the normal duration of the Masters course (eg 2 years) and the structure of the course (eg minimum of 24 points of which 18 are a research project). Information about my position in my graduating class list (eg 25th from a class of 250). An official statement from my previous Australian university or universities where I was enrolled in a graduate research degree. This statement includes detailed information about my enrolment periods, fulltime or part-time status, any scholarships received and total consumed Equivalent Full-Time Student Load (EFTSL). Examiners reports for any major research project (eg a thesis) that I completed as part of my fourth year or higher tertiary studies. CRICOS Provider Number: 00116K Page 14 of 15

Additional Documentation (as applicable, continued) Evidence of awarded sponsorships, scholarships or research grants, including details of funding bodies and duration. Faculty/Graduate School specific research proposal and/or writing sample. Please indicate what you have included: Faculty/Graduate School specific test scores (eg the GRE, GMAT, etc). An original or certified official letter from previous tertiary institutions confirming that I have completed a qualification because my transcripts do not specifically state that I have completed the degree. Certified English translations of all documents that are not originally in English. Certified copy of an official document that indicates a legal change of name because my current name is not the same as that on my transcripts, testamurs or diplomas. Official advice from my current or previous university detailing the actual numeric marks (eg 82) or Grade Point Average (eg 3.4 out of 4.0) that I achieved in my tertiary studies. Academic Referee Reports according to the requirements outlined at the beginning of this application form. Please specify whether you have included one or two reports: 1 2 Referee reports mailed with your application should be in sealed envelopes with the referee s signature across the seal. Employer Referee Reports. Please specify the number of reports included with your application here: Referee reports mailed with your application should be in sealed envelopes with the referee s signature across the seal. Evidence that I satisfy the English language proficiency requirements for admission to graduate study in my prospective Faculty/Graduate School at the University of Melbourne. Documentary evidence of the award of a medical fellowship or completion of the first three years of clinical fellowship training. Documentary evidence for all relevant publications and/or creative works listed in my CV/resume. Additional scholarship application materials: Documentation That Will be Submitted Separately Please note that submitting an incomplete application will cause significant delays and may prevent your application from being processed. Documents other than those listed below should always be included with your application form to avoid processing delays. The following documentation will be or has been submitted separately: Final academic transcripts for a course in which I am currently enrolled. Faculty/Graduate School specific test scores (eg the GRE, GMAT, etc). Academic IELTS or TOEFL test scores. Academic Referee Reports according to the requirements outlined at the beginning of this application form will be submitted by my referee(s) according to the instructions found on the form. Please specify whether you have requested one or two reports: 1 2 Employer Referee Reports will be submitted by my referee(s) according to the instructions found on the form. Please specify the number of reports that you have requested: Required assessment materials and/or forms have been sent directly to my prospective Faculty/Graduate School or department according to their specific guidelines (eg portfolios, DVDs, CDs, etc for the evaluation of creative works). Please specify: Other documentation. Please specify: CRICOS Provider Number: 00116K Page 15 of 15