2023 Shafston Agent Questionnaire

Step 1 of 7

The purpose of this questionnaire is to assist Shafston in its appointment of new agents to recruit international fee-paying students.

Organisation Details

Legal Entity(Required)

Trading Name(Required)

ABN(Required)

(Australian organisations only)

GST(Required)

(Australian organisations only)

General Email Address(Required)

Enter Email Confirm Email

Phone Number(Required)

Website URL(Required)

Workplace Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Postal Address(Required)

Same as Workplace

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Section D - Australian References

Reference 1

Name of Referee 1(Required)

First Last

Business Name(Required)

Email(Required)

Phone(Required)

Referee Business Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Reference 2

Name of Referee 2(Required)

First Last

Business Name(Required)

Email(Required)

Phone(Required)

Business Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

BRISBANE CAMPUS

46 Thorn St, Kangaroo Point
Brisbane QLD 4169 Australia
+61 (0)7 3249 4111
info@shafston.edu

GOLD COAST CAMPUS

72 Nerang St, Southport
Gold Coast QLD 4215 Australia
+61 (0)7 3249 4111
info@shafston.edu

BUSINESS HOURS

Monday – Friday
8:30am – 5:00pm
Saturday – Sunday
Closed

CRICOS Provider Code:03917H | RTO Code:45694

CAMBRIDGE EXAM REGISTRATION FORM - ALL

PLEASE NOTE THAT YOUR APPLICATION WILL NOT BE PROCESSED UNTIL PAYMENT HAS BEEN RECEIVED. EXAM FEES ARE NON-REFUNDABLE AFTER EXAM REGISTRATION CLOSING DATE

Step 1 of 4

PLEASE NOTE THAT YOUR APPLICATION WILL NOT BE PROCESSED UNTIL PAYMENT HAS BEEN RECEIVED. EXAM FEES ARE NON-REFUNDABLE AFTER EXAM REGISTRATION CLOSING DATE
EXAM DETAIL
NOTE: If you do not read or understand English well, we strongly suggest you have an interpreter/translator explain this form prior to signing.
EXAM TYPE(Required)
EXAM DATE - B2 First exam (FCE)(Required)
EXAM DATE - C1 Advanced exam (CAE)(Required)
EXAM DATE - C2 Proficiency (CPE)(Required)

Examinee’s Personal Details
Full Name(Required)
First Last
Gender(Required)
Date of Birth(Required)
DD slash MM slash YYYY
Country of Birth(Required)
Nationality(Required)
Passport No(Required)
Phone(Required)
Home Phone

Optional
Email(Required)
Enter Email Confirm Email
Residence Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
If you are already in Australia, what is your current visa type?(Required)
How did you hear about us?(Required)

Certificate Collection
Please indicate below if you would like SHAFSTON to send you Certificate via Registered Mail OR if you will be collecting the Certificate in person
I would like SHAFSTON to send my certificate to my Postal Address(Required)
- YES (postage fee applies)
- NO, I will collect my Certificate from SHAFSTON (4-6 weeks after results)
Postal Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
DECLARATION
CONSENT
I hereby confirm that my payment of the fees as invoiced, in conjunction with my signing of this form, constitutes my acceptance of the terms of my agreement with Shafston International College in relation to my enrolment. I have read and agree to be bound by all of the Conditions of Enrolment as detailed below.
CONDITIONS OF ENROLMENT

1. Complete your online Cambridge Exam Registration form

2. Make a payment directly with the online registration form

3. Payment may be made by Paypal or credit card. Personal cheques cannot be accepted. If you have any issues with payment, please email cambridge@shafston.edu

4. In the absence of any agreement to the contrary, your application to register for a Cambridge exam will not be confirmed until fees are received and our bank has confirmed your payment.

5. Cancellations are not effective until they are received in writing.

6. Refunds will not be paid if cancellation takes place after the Exam Registration Closing Date. This date will be confirmed by the Centre Exams Manager.

7. Refunds will only be paid in the same currency in which fees were collected, and paid to the person who entered into the contract. We require a written direction from the applicant to refund to another party.

8. The personal information you provide to us or is obtained about you will be regarded as confidential and will be used for the purpose of processing your application and providing you with the services you request. However, in this process, it may be disclosed to relevant third parties including your family, homestay families, agents, further studies institutions, the Australian Government, the Fund Manager of the ESOS Assurance Fund, other statutory bodies and various employees of the College as required.
Examinee’s Full Name (please print):(Required)
First Last
Examine Signature(Required)
Signed Date(Required)
DD slash MM slash YYYY
Is the examinee under eighteen (18) years of age?(Required)
- YES
- NO
Name(Required)
Parent or Legal Guardian must sign where student is under eighteen (18) years of age.
First Last
Parent or Legal Guardian Signature(Required)
Signed Date(Required)
DD slash MM slash YYYY
NOTE: If you do not read or understand English well, we strongly suggest you have an interpreter/translator explain this form prior to signing.

CAMBRIDGE EXAM REGISTRATION FORM - CAE

PLEASE NOTE THAT YOUR APPLICATION WILL NOT BE PROCESSED UNTIL PAYMENT HAS BEEN RECEIVED. EXAM FEES ARE NON-REFUNDABLE AFTER EXAM REGISTRATION CLOSING DATE

Step 1 of 4

PLEASE NOTE THAT YOUR APPLICATION WILL NOT BE PROCESSED UNTIL PAYMENT HAS BEEN RECEIVED. EXAM FEES ARE NON-REFUNDABLE AFTER EXAM REGISTRATION CLOSING DATE
EXAM DETAIL
NOTE: If you do not read or understand English well, we strongly suggest you have an interpreter/translator explain this form prior to signing.
EXAM DATE - Cambridge English: C1 Advanced (CAE)(Required)
- 09 SEPTEMBER 2023 - SAT
- 29 NOVEMBER 2023 - WED

Examinee’s Personal Details
Full Name(Required)
First Last
Gender(Required)
Date of Birth(Required)

Day
Month
Year
Country of Birth(Required)
Nationality(Required)
Passport No(Required)
Phone(Required)
Home Phone

Optional
Email(Required)
Enter Email Confirm Email
Residence Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
If you are already in Australia, what is your current visa type?(Required)
How did you hear about us?(Required)

Certificate Collection
Please indicate below if you would like SHAFSTON to send you Certificate via Registered Mail OR if you will be collecting the Certificate in person
I would like SHAFSTON to send my certificate to my Postal Address(Required)
- YES (postage fee applies)
- NO, I will collect my Certificate from SHAFSTON (4-6 weeks after results)
Postal Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
DECLARATION
CONSENT
I hereby confirm that my payment of the fees as invoiced, in conjunction with my signing of this form, constitutes my acceptance of the terms of my agreement with Shafston International College in relation to my enrolment. I have read and agree to be bound by all of the Conditions of Enrolment as detailed below.
CONDITIONS OF ENROLMENT

1. Complete your online Cambridge Exam Registration form

2. Make a payment directly with the online registration form

3. Payment may be made by Paypal or credit card. Personal cheques cannot be accepted. If you have any issues with payment, please email cambridge@shafston.edu

4. In the absence of any agreement to the contrary, your application to register for a Cambridge exam will not be confirmed until fees are received and our bank has confirmed your payment.

5. Cancellations are not effective until they are received in writing.

6. Refunds will not be paid if cancellation takes place after the Exam Registration Closing Date. This date will be confirmed by the Centre Exams Manager.

7. Refunds will only be paid in the same currency in which fees were collected, and paid to the person who entered into the contract. We require a written direction from the applicant to refund to another party.

8. The personal information you provide to us or is obtained about you will be regarded as confidential and will be used for the purpose of processing your application and providing you with the services you request. However, in this process, it may be disclosed to relevant third parties including your family, homestay families, agents, further studies institutions, the Australian Government, the Fund Manager of the ESOS Assurance Fund, other statutory bodies and various employees of the College as required.
Examinee’s Full Name (please print):(Required)
First Last
Examinee’s Signature:(Required)
Signed Date(Required)
DD slash MM slash YYYY
Is the examinee under eighteen (18) years of age?(Required)
- YES
- NO
Name(Required)
Parent or Legal Guardian must sign where student is under eighteen (18) years of age.
First Last
Parent/Guardian’s Signature:(Required)
Signed Date(Required)
DD slash MM slash YYYY
NOTE: If you do not read or understand English well, we strongly suggest you have an interpreter/translator explain this form prior to signing.

CAMBRIDGE EXAM REGISTRATION FORM - CPE

PLEASE NOTE THAT YOUR APPLICATION WILL NOT BE PROCESSED UNTIL PAYMENT HAS BEEN RECEIVED. EXAM FEES ARE NON-REFUNDABLE AFTER EXAM REGISTRATION CLOSING DATE

Step 1 of 4

PLEASE NOTE THAT YOUR APPLICATION WILL NOT BE PROCESSED UNTIL PAYMENT HAS BEEN RECEIVED. EXAM FEES ARE NON-REFUNDABLE AFTER EXAM REGISTRATION CLOSING DATE
EXAM DETAIL
NOTE: If you do not read or understand English well, we strongly suggest you have an interpreter/translator explain this form prior to signing.
EXAM DATE - Cambridge English: C2 Proficiency (CPE)(Required)
- 30 NOVEMBER 2023 - THUR

Examinee’s Personal Details
Full Name(Required)
First Last
Gender(Required)
Date of Birth(Required)

Day
Month
Year
Country of Birth(Required)
Nationality(Required)
Passport No(Required)
Phone(Required)
Home Phone

Optional
Email(Required)
Enter Email Confirm Email
Residence Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
If you are already in Australia, what is your current visa type?(Required)
How did you hear about us?(Required)

Certificate Collection
Please indicate below if you would like SHAFSTON to send you Certificate via Registered Mail OR if you will be collecting the Certificate in person
I would like SHAFSTON to send my certificate to my Postal Address(Required)
- YES (postage fee applies)
- NO, I will collect my Certificate from SHAFSTON (4-6 weeks after results)
Postal Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
DECLARATION
CONSENT
I hereby confirm that my payment of the fees as invoiced, in conjunction with my signing of this form, constitutes my acceptance of the terms of my agreement with Shafston International College in relation to my enrolment. I have read and agree to be bound by all of the Conditions of Enrolment as detailed below.
CONDITIONS OF ENROLMENT

1. Complete your online Cambridge Exam Registration form

2. Make a payment directly with the online registration form

3. Payment may be made by Paypal or credit card. Personal cheques cannot be accepted. If you have any issues with payment, please email cambridge@shafston.edu

4. In the absence of any agreement to the contrary, your application to register for a Cambridge exam will not be confirmed until fees are received and our bank has confirmed your payment.

5. Cancellations are not effective until they are received in writing.

6. Refunds will not be paid if cancellation takes place after the Exam Registration Closing Date. This date will be confirmed by the Centre Exams Manager.

7. Refunds will only be paid in the same currency in which fees were collected, and paid to the person who entered into the contract. We require a written direction from the applicant to refund to another party.

8. The personal information you provide to us or is obtained about you will be regarded as confidential and will be used for the purpose of processing your application and providing you with the services you request. However, in this process, it may be disclosed to relevant third parties including your family, homestay families, agents, further studies institutions, the Australian Government, the Fund Manager of the ESOS Assurance Fund, other statutory bodies and various employees of the College as required.
Examinee’s Full Name (please print):(Required)
First Last
Examinee’s Signature:(Required)
Signed Date(Required)
DD slash MM slash YYYY
Is the examinee under eighteen (18) years of age?(Required)
- YES
- NO
Name(Required)
Parent or Legal Guardian must sign where student is under eighteen (18) years of age.
First Last
Parent/Guardian’s Signature:(Required)
Signed Date(Required)
DD slash MM slash YYYY
NOTE: If you do not read or understand English well, we strongly suggest you have an interpreter/translator explain this form prior to signing.

CAMBRIDGE EXAM REGISTRATION FORM - FCE

PLEASE NOTE THAT YOUR APPLICATION WILL NOT BE PROCESSED UNTIL PAYMENT HAS BEEN RECEIVED. EXAM FEES ARE NON-REFUNDABLE AFTER EXAM REGISTRATION CLOSING DATE

Step 1 of 4

PLEASE NOTE THAT YOUR APPLICATION WILL NOT BE PROCESSED UNTIL PAYMENT HAS BEEN RECEIVED. EXAM FEES ARE NON-REFUNDABLE AFTER EXAM REGISTRATION CLOSING DATE
EXAM DETAIL
NOTE: If you do not read or understand English well, we strongly suggest you have an interpreter/translator explain this form prior to signing.
EXAM DATE - Cambridge English: B2 First (FCE)(Required)
- 24 AUGUST 2023 - THUR
- 28 NOVEMBER 2023 - TUE

Examinee’s Personal Details
Full Name(Required)
First Last
Gender(Required)
Date of Birth(Required)

Day
Month
Year
Country of Birth(Required)
Nationality(Required)
Passport No(Required)
Phone(Required)
Home Phone

Optional
Email(Required)
Enter Email Confirm Email
Residence Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
If you are already in Australia, what is your current visa type?(Required)
How did you hear about us?(Required)

Certificate Collection
Please indicate below if you would like SHAFSTON to send you Certificate via Registered Mail OR if you will be collecting the Certificate in person
I would like SHAFSTON to send my certificate to my Postal Address(Required)
- YES (postage fee applies)
- NO, I will collect my Certificate from SHAFSTON (4-6 weeks after results)
Postal Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
DECLARATION
CONSENT
I hereby confirm that my payment of the fees as invoiced, in conjunction with my signing of this form, constitutes my acceptance of the terms of my agreement with Shafston International College in relation to my enrolment. I have read and agree to be bound by all of the Conditions of Enrolment as detailed below.
CONDITIONS OF ENROLMENT

1. Complete your online Cambridge Exam Registration form

2. Make a payment directly with the online registration form

3. Payment may be made by Paypal or credit card. Personal cheques cannot be accepted. If you have any issues with payment, please email cambridge@shafston.edu

4. In the absence of any agreement to the contrary, your application to register for a Cambridge exam will not be confirmed until fees are received and our bank has confirmed your payment.

5. Cancellations are not effective until they are received in writing.

6. Refunds will not be paid if cancellation takes place after the Exam Registration Closing Date. This date will be confirmed by the Centre Exams Manager.

7. Refunds will only be paid in the same currency in which fees were collected, and paid to the person who entered into the contract. We require a written direction from the applicant to refund to another party.

8. The personal information you provide to us or is obtained about you will be regarded as confidential and will be used for the purpose of processing your application and providing you with the services you request. However, in this process, it may be disclosed to relevant third parties including your family, homestay families, agents, further studies institutions, the Australian Government, the Fund Manager of the ESOS Assurance Fund, other statutory bodies and various employees of the College as required.
Examinee’s Full Name (please print):(Required)
First Last
Signed Date(Required)
DD slash MM slash YYYY
Is the examinee under eighteen (18) years of age?(Required)
- YES
- NO
Name(Required)
Parent or Legal Guardian must sign where student is under eighteen (18) years of age.
First Last
Signed Date(Required)
DD slash MM slash YYYY
NOTE: If you do not read or understand English well, we strongly suggest you have an interpreter/translator explain this form prior to signing.