Personal Details

Privacy Policy
The information on this form is being collected for further communication with you regarding various courses, programs and events at the Melbourne Business School which you have expressed interest. Information collected will only be used for the purpose for which it was collected. The Melbourne Business School's Privacy Policy is available online at:


If yes to either of the above, please provide your student number if readily available.
I am a current University of Melbourne Staff Member
We will contact you to verify your staff status if a UoM staff discount applies.

Contact Details

Emergency contact details

Course & Subjects

Please select at least 2 Cores and 2 Electives:



Specialist Certificate in Leadership

Citizenship Status

Please indicate your citizenship status and country of birth:


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English Language Proficiency

If yes, please supply a copy of your IELTS or TOEFL test completed within the last 2 years.

Note, all applicants must satisfy the University's English Language Requirements.

If you completed your previous tertiary study in a country where English is not the first

language, you may be required to submit further documentation.

Further details can be found at

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Previous Tertiary Studies

Tick and upload the documentation that you are submitting.
Certified copies of your academic transcripts which show you meet the entry requirements of the course.
  • Transcripts are not required if you completed your undergraduate studies at the University of Melbourne.
  • A certified translation is required if your transcripts are not in English.
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Professional Work Experience

Tick and upload the documentation that you are submitting.
A copy of your resume detailing your relevant professional work.
A letter from your current employer outlining the length of your employment and its relevance to the course.
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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.

I hereby authorise the University of Melbourne and Melbourne Business School to make enquiries and obtain official records from any university and tertiary institution concerning my current and previous attendance which, in its absolution discretion, it believes are necessary.

I acknowledge that my failure to disclose my true and complete tertiary record may result in my being excluded from the University and / or Melbourne Business School.

I further declare that all the 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.

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.

I declare that I will be able to abide by the University's policy regarding refunds outlined in the Arrangements Relating to the Payment of my Student Fees.

I understand the University and Melbourne Business School reserves the right to inform other tertiary institutions if any of the material presented to support my application is found to be false.

All documents submitted become the property of the University of Melbourne and Melbourne Business School.

I understand that the University of Melbourne and Melbourne Business School may disclose the personal information I have given in this application form to the Department of Education, Employment and Workplace Relations (DEEWR) and that DEEWR will collect and store my personal information to the Higher Education Information Management System.

I authorise the University of Melbourne and Melbourne Business School to release my academic results to my sponsor for the duration of my enrolment in this course.

Please refer to for the University's Privacy Policy and to for the Melbourne Business School's Privacy Policy.

I hereby declare that I have read and understood the above conditions and agree to be bound by those conditions.