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Title
Given Name*
Family Name*
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Mobile phone number
Where do you live?*
Is this your country of citizenship as well?*
Are you in secondary school? If so, let us know the name of your school/institution:
When do you wish to commence your next course at the University of Melbourne?*
+ Do you fit into any of the following categories?
Are you eligible for special entry through Access Melbourne? (Access Melbourne is our special entry and access scheme, to find out more please visit - https://access.unimelb.edu.au)
Are you a potential Mature Age Student/Non School Leaver? (Not sure? To find out more please visit - https://futurestudents.unimelb.edu.au/nonyear12)
Do you identify as Australian Aboriginal or Torres Strait Islander?
What is the nature of your enquiry?*
Enquiry description*

What Undergraduate courses are you interested in? (Tick all that apply) *
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Have you ever been a student, or made an application to the University of Melbourne? If so, please let us know your Student ID/Application Number (if you know it):
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