Application form – Undergraduate Certificates – Domestic Students Student typeDomesticBefore you commence your application Endeavour provides detailed information regarding applying with the College on our website at: https://www.endeavour.edu.au/apply-to-study/domestic-students/. It is advised that you keep this page open whilst completing your application to reference important information regarding course viability, intakes, census dates, fees and entry requirements. Acknowledgement - Application information* I confirm that I have reviewed and understand the information provided for applying with Endeavour College of Natural Health and I am ready to commence my application. Full name* Mr.Mrs.MissMs.Mx.Dr.Prof.Rev. Prefix First Middle (if applicable) Last Have you been known by a previous name?*YesNoPlease provide your previous name/s*You can add multiple names if required by clicking the + icon.First nameMiddle nameSurname Email address* Enter email Confirm email Are you over 18 years of age at the time of this application?*YesNoPlease note: As per Endeavour College's entry requirements, you must be 18 years of age to study our Undergraduate Certificate's. Please complete a course enquiry if you would like to speak to admissions regarding future study at the College.Have you previously studied with Endeavour College of Natural Health?*YesNoHow did you hear about Endeavour College of Natural Health?*Endeavour StaffSearchSocial MediaInternet AdvertisingRadioOutdoor / Cinema / TVMagazine / NewspaperReferral / Professional AssociationEvent / ExpoUniversity GuideDirect / WebsiteHave you spoken with someone from the Endeavour Admissions team?*YesNoIf Yes, please enter their nameIf you cannot remember the name of the Admissions Team member you spoke to, please leave this field blank. Course and campusSelect the course you wish to apply for*Undergraduate Certificate in Lifestyle CoachingUndergraduate Certificate in History and Philosophy of Complementary MedicineUndergraduate Certificate in Building Health Through NutritionUndergraduate Certificate in Human BiologyCampus selection*Although our Undergraduate Certificates are fully online courses, please select the closest Endeavour College campus to you.AdelaideBrisbaneGold CoastMelbournePerthSydneyStudy optionsStudy load*Full timePart timePlease select your preferred course commencement period*January onlineFebruary onlineMarch onlineApril onlineMay onlineJune onlineJuly onlineAugust onlineSeptember onlineOctober onlineNovember onlineDecember online Personal detailsGender*MaleFemalePrefer not to sayDate of birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Address detailsPostal address* Street Address Suburb ACTNSWNTQLDSATASVICWAInternational State Postcode Home address* Same as postal address Street Address Suburb ACTNSWNTQLDSATASVICWAInternational State Postcode Contact detailsPrimary contact number*Home, work or mobile.Alternate contact numberComplete only if applicable.Emergency/next of kin contact detailsContact name* Mr.Mrs.MissMs.Mx.Dr.Prof.Rev. Prefix First name Last name Relationship to you*Contact number*Contact address* Street Address City State Postcode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Security password*Your security password enables Endeavour College of Natural Health to provide private information to your next of kin. Citizenship, ethnicity & languageDo you identify with any of the following groups?* Aboriginal Torres Strait Islander N/A Were you born in Australia?*YesNoWhat is your country of birth?*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweYear of arrival to Australia*Select all that apply* I am an Australian permanent resident or a New Zealand citizen I have attended a citizenship ceremony and received an Australian Citizenship Certificate I hold a permanent Humanitarian Visa None of the above Please note: Unfortunately our Undergraduate Certificate's are currently not available for international students. Please complete a course enquiry if you would like to speak to admissions regarding future study at the College.Is English the primary language spoken at home?*YesNoIf no, what is the primary language spoken at home?*Proficiency in spoken English*Very wellWellNo wellNot at all Special conditionsDo you have a disability, impairment or long term medical condition which may affect your studies?*YesNoPlease indicate the area/s of impairment*Select any that apply. Developmental Hearing Intellectual Medical Neurological Physical Psychiatric Speech Vision Other Please specify*Would you like to receive advice on support services, equipment and facilities which may assist you?*YesNoEducation historyPlease select the qualifications that you have previously COMPLETED*You can select more than one. Certificate I Certificate II Certificate III Certificate IV Diploma Advanced Diploma or Associate Degree Bachelor Degree Graduate Diploma or Graduate Certificate Master Degree Doctoral Degree None of these What is the highest level of education you have STARTED?*PostgraduateDegreeHigher Education sub-degree courseCertificate/DiplomaYear 12 (or equivalent)Year 10 (or equivalent)Name of qualification/s*You can add more than one qualification by clicking the + icon What year were you last enrolled in study?*Name of previous education provider*Have you completed year 12 (or equivalent)?*YesNoWhat year were you last enrolled in year 12 study (or equivalent)?*Year you completed year 12 (or equivalent)?*Name of your school*Postcode of your school*What was your overall secondary school ranking?*OP/FP/ATAR/TE - If not known or not applicable, please type n/a.Did you complete a year 12 certificate?*YesNoWhich year 12 certificate did you complete?*HSC – New South WalesVCE or VCAL – VictoriaQCE – QueenslandWACE – Western AustraliaSACE – South AustraliaTCE – TasmaniaACT – ACTNTCET – NTParent/Guardian education detailsFor reporting purposes we require information regarding the highest level of education completed by your Parent/Guardian.Parent/Guardian 1 - Gender*MaleFemalePrefer not to sayParent/Guardian 1 - Highest level of education completed*Post Graduate (e.g. Grad Dip, Masters, PhD)Bachelor degreeOther post-school qualification (e.g. Associate degree, diploma, advanced diploma)Completed apprenticeship &/or VET/TAFE certificateCompleted Year 12 schooling (or equivalent)Completed Year 10 schooling (or equivalent) and continued at school, but didn’t complete year 12Completed Year 10 schooling (or equivalent)Left school before completing Year 10Don’t knowWould you like to enter details regarding another Parent/Guardian?*YesNoParent/Guardian 2 - Gender*MaleFemalePrefer not to sayParent/Guardian 2 - Highest level of education completed*Post Graduate (e.g. Grad Dip, Masters, PhD)Bachelor degreeOther post-school qualification (e.g. Associate degree, diploma, advanced diploma)Completed apprenticeship &/or VET/TAFE certificateCompleted Year 12 schooling (or equivalent)Completed Year 10 schooling (or equivalent) and continued at school, but didn’t complete year 12Completed Year 10 schooling (or equivalent)Left school before completing Year 10Don’t knowAre you the first in your immediate family to study at a higher education institution?*YesNoEmploymentWhich of the following best describes your employment status?*EmployedSelf-employedUnemployed - seeking workUnemployed - not seeking workWhat is your current occupation?* Tuition fees & assistanceMethod of tuition fee payment*FEE-HELPSelf funding tuition feesSplit payment using FEE-HELP & self fundingDo you have an Australian Government USI (Unique student identifier)?*If you are undertaking a higher education qualification, you need a USI in order to receive commonwealth financial assistance (FEE-HELP), as well as to obtain your qualification. You can check if you have a USI (or create one) here: https://www.usi.gov.au/faqs/find-your-usiYesNoWhat is your USI (Unique student identifier)?*Declaration of provision of USI to the College* I understand that I will be required to provide the College with my USI (Unique student identifier) prior to receiving any confirmation of enrolment Have you previously accessed HELP (HECS-HELP, FEE-HELP, VET FEE-HELP)?*YesNoWhat is your CHESS Number (if known)?You would have received a CHESS (Commonwealth Higher Education Student Support) Number from your previous provider. You can find your CHESS Number on your CAN (Commonwealth Assistance Notice). Declaration and understanding of application and enrolmentI hereby declare that...* I have read the instructions for completing my application and that the information I have provided in connection with this application is true and complete. It is my responsibility to enrol correctly and understand that I must ONLY enrol in units that comply with the requirements of my course. I meet the pre-requisite requirements for entry to my chosen course. I agree to meet all enrolment deadlines and make payment of all fees arising from this enrolment by their due date. I understand that I must accept the consequences of not meeting these due dates in accordance with instructions either published by the College or sent to me in any correspondence from the College relating to my enrolment. I am aware of the College's Tuition Fee schedule for my chosen course. I am aware of the College's intake and census dates relating to my chosen course and method of study. I understand that delivery modes may be revised or cancelled and I may be required to swap delivery modes (for Bachelor of Health Science programs only) or intake months. I have read and understood the system requirements for online study and I confirm that I will have access to a computer and internet with the minimum specifications required. The College's policies and procedures have been made available to me online and I have read, understood and accepted these as conditions of my enrolment. I have read, and agree to abide by the Endeavour College Student Code of Conduct While I am enrolled, I will comply with the rules, policies and by-laws of the College. I understand if I am enrolling now or at a later time into a Undergraduate Certificate program...* Endeavour College of Natural Health is collecting the information on this form, and on my Enrolment Form for the purpose of assessing my entitlement to Commonwealth Assistance under the Higher Education Support Act 2003 and allocation of a Commonwealth Higher Education Student Support Number [CHESSN] to me. Endeavour College of Natural Health will disclose this information to the Australian Government Department of Education for those purposes. Australian Government Department of Education will store the information securely in the Higher Education Information Management System Australian Government Department of Education may disclose the information to the Australian Taxation Office. Endeavour College of Natural Health and Australian Government Department of Education will not otherwise disclose the information without my consent unless required or authorised by law. Signature*Date Date Format: DD slash MM slash YYYY Final reviewPlease review the information you have provided prior to submitting your application.{all_fields:noadmin}