Preliminary Apply Form

There is an error while loading course information. Please try again later

Invalid program selected

Invalid course selected

Course Information

Invalid campus selected

Course Information

Invalid course selected

General Details

Title is a required field

Given name is a required field

Given name should not contain numbers or special characters

Surname is a required field

Surname should not contain numbers or special characters

Date of Birth is a required field

Residency Information is a required field

This is a required field

This is a required field

Contact and Residential Address Details

Provided USI number is not valid

Email is a required field

Email address is invalid or contains special characters

Confirm email is a required field

Email address does not match

Invalid contact number

Please check your phone number

An Address is required

  • {{item.AddressFull}}

Street/Lot Number is a required field

Street is a required field

e.g. BROADMEADOWS

Suburb is a required field

Please enter a valid suburb

e.g. VIC

Please enter a valid Australian State

Please enter a valid state

e.g. 3047

Post code is a required field

Country is a required field

Can not enter P.O. Box as residential address

Submit

Can't submit multiple times

By submitting this form I agree that Bendigo Kangan Institute may use my personal information to contact me about products and services provided by Bendigo Kangan Institute and it’s partners. I understand that Bendigo Kangan Institute may profile and share my personal data with its agents for the purposes of marketing fulfilment. From time to time, Bendigo Kangan Institute may contact me by mail, telephone, email, other electronic messaging services (such as text, voice, sound or image messages including using automated calling systems) or fax with information about Bendigo Kangan Institute’s products and services. I understand that I can opt out of receiving this information at any time by writing to Bendigo Kangan Institute, Pearcedale Parade, Broadmeadows or by calling 138 233.

Course Application

Your application has been sent successfully. You will soon receive an email to log in and complete your online application.