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AUSSIE HOUSE
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Application Form
First name
Last name
Email
Counsellor Email
Gender
Female
Male
Other
Birthday
Day
Month
Month
Year
Nationality
Passport Number
File upload
Upload File
Type of Visa
File upload
Upload File
Home Address
Phone Number
Which location would you like to apply to
Melbourne - Australia
Gold Coast (Southport) - Australia
Gold Coast (Surfers Paradise) - Australia
Gold Coast (Broadbeach) - Australia
Dubai - EAU
Accommodation start date
Accommodation finish date
Accommodation type
Shared Room Standard
Shared Room VIP (Private Bathroom)
Private Room Standard
Private Room VIP (Private Bathroom)
Submit
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