Built Environment Application Please leave this field empty. Required fields denoted with an asterisk * Personal Details TitleMRMSMx First Name Last Name Preferred Name Contact Number 1 Contact Number 2 Nationality Email Address 1 Email Address 2 Are you an Australian citizen or permanent resident?* —Please choose an option—Yes, I am an Australian citizenYes, I am an Australian permanent residentNo Gender * MaleFemaleUndefined Postal Address Number and Street City State Postcode CountryArubaAfghanistanAngolaAnguillaÅland IslandsAlbaniaAndorraUnited Arab EmiratesArgentinaArmeniaAmerican SamoaAntarcticaFrench Southern TerritoriesAntigua and BarbudaAustraliaAustriaAzerbaijanBurundiBelgiumBeninBonaire, Sint Eustatius and SabaBurkina FasoBangladeshBulgariaBahrainBahamasBosnia and HerzegovinaSaint BarthélemyBelarusBelizeBermudaBolivia, Plurinational State ofBrazilBarbadosBrunei DarussalamBhutanBouvet IslandBotswanaCentral African RepublicCanadaCocos (Keeling) IslandsSwitzerlandChileChinaCôte d'IvoireCameroonCongo, Democratic Republic of theCongoCook IslandsColombiaComorosCabo VerdeCosta RicaCubaCuraçaoChristmas IslandCayman IslandsCyprusCzechiaGermanyDjiboutiDominicaDenmarkDominican RepublicAlgeriaEcuadorEgyptEritreaWestern SaharaSpainEstoniaEthiopiaFinlandFijiFalkland Islands (Malvinas)FranceFaroe IslandsMicronesia, Federated States ofGabonUnited Kingdom of Great Britain and Northern IrelandGeorgiaGuernseyGhanaGibraltarGuineaGuadeloupeGambiaGuinea-BissauEquatorial GuineaGreeceGrenadaGreenlandGuatemalaFrench GuianaGuamGuyanaHong KongHeard Island and McDonald IslandsHondurasCroatiaHaitiHungaryIndonesiaIsle of ManIndiaBritish Indian Ocean TerritoryIrelandIran, Islamic Republic ofIraqIcelandIsraelItalyJamaicaJerseyJordanJapanKazakhstanKenyaKyrgyzstanCambodiaKiribatiSaint Kitts and NevisKorea, Republic ofKuwaitLao People's Democratic RepublicLebanonLiberiaLibyaSaint LuciaLiechtensteinSri LankaLesothoLithuaniaLuxembourgLatviaMacaoSaint Martin (French part)MoroccoMonacoMoldova, Republic ofMadagascarMaldivesMexicoMarshall IslandsNorth MacedoniaMaliMaltaMyanmarMontenegroMongoliaNorthern Mariana IslandsMozambiqueMauritaniaMontserratMartiniqueMauritiusMalawiMalaysiaMayotteNamibiaNew CaledoniaNigerNorfolk IslandNigeriaNicaraguaNiueNetherlands, Kingdom of theNorwayNepalNauruNew ZealandOmanPakistanPanamaPitcairnPeruPhilippinesPalauPapua New GuineaPolandPuerto RicoKorea, Democratic People's Republic ofPortugalParaguayPalestine, State ofFrench PolynesiaQatarRéunionRomaniaRussian FederationRwandaSaudi ArabiaSudanSenegalSingaporeSouth Georgia and the South Sandwich IslandsSaint Helena, Ascension and Tristan da CunhaSvalbard and Jan MayenSolomon IslandsSierra LeoneEl SalvadorSan MarinoSomaliaSaint Pierre and MiquelonSerbiaSouth SudanSao Tome and PrincipeSurinameSlovakiaSloveniaSwedenEswatiniSint Maarten (Dutch part)SeychellesSyrian Arab RepublicTurks and Caicos IslandsChadTogoThailandTajikistanTokelauTurkmenistanTimor-LesteTongaTrinidad and TobagoTunisiaTürkiyeTuvaluTaiwan, Province of ChinaTanzania, United Republic ofUgandaUkraineUnited States Minor Outlying IslandsUruguayUnited States of AmericaUzbekistanHoly SeeSaint Vincent and the GrenadinesVenezuela, Bolivarian Republic ofVirgin Islands, BritishVirgin Islands, U.S.Viet NamVanuatuWallis and FutunaSamoaYemenSouth AfricaZambiaZimbabwe University Details Please note that this program is only open to students from one of: Federation University; Swinburne University; University of Melbourne; or Victoria University. Which university do you attend? —Please choose an option—Victoria UniversitySwinburne UniversityFederation UniversityUniversity of Melbourne Student ID Number Course Name Current WAM/GPA/average mark Major 1 Major 2 Major 3 Are you doing this internship for credit at your university?* YesNoUnsure If yes, what is the name of the unit that you will apply for? If yes, what is the name of the unit that you will apply for? New Colombo Plan To be eligible to receive a New Colombo Plan (NCP) grant you must satisfy the following criteria: 1. You are an undergraduate student at one of the listed consortium universities; 2. The experience will count towards your degree; 3. You are an Australian citizen and do not concurrently hold, nor have you previously held, Indonesian citizenship; 4. You have not previously received a short-term NCP grant for a virtual (online) mobility experience (it is fine if you have already received a grant for a short-term in-country experience) I confirm that I satisfy the listed criteria and would like to be considered for an NCP grantI acknowledge that I will not be considered for an NCP grant CV and Statement of Intent Please upload your CV. Please ensure that this is representative of your achievements and capabilities, looks clean and has consistent formatting. Attach File * (5MB max) Please provide a statement of intent explaining the following: 1. Why you want to join this program; and 2. What skills you are seeking from the program (e.g. professional skills, technical skills, soft skills). * Statement of Intent Other Do you speak any Indonesian (Note that this is NOT a requirement of the program)? * NoneBasicModerateFluent How did you hear about this program? *—Please choose an option—A friend who did it previouslyFrom a course adviserFrom your lecturerLecture visit by an International Internships team member or past participantEmail sent by your universityOnline info provided by your universityOnline searchOther Terms and Conditions * I have read the Terms And Conditions I have read and accept the Terms and Conditions (Link opens in a new window) Yes, share my details I am happy for International Internships to share my contact details with other interns that will be in Indonesia at the same time as me. Please provide any other information that you think may be of relevance to your application. Other Information Send
