Student Membership Application Form Student Membership Application Form For any enquiry, please contact sovann.eu@vicwise.org Membership Fee: Student – non-transferable Membership is $10 + GST, valid for one year (Jan – Dec). Applicant information StatusPendingActiveCancelledExpiredActive DateExpire DateFirst Name*Last Name*Middle NameAre you under 18?*Please choose oneYesNoCountry of origin*Please choose oneAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina (excludes SARs and Taiwan)ColombiaComorosCongo (Brazzavile)Congo (Kinshasa)Cook IslandsCosta RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzechia (Czech Republic)DenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor-Leste)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (fmr. “Swaziland”)EthiopiaFaeroe IslandsFalkland IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGaza Strip and West BannGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuinea-BissauGuineaGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory Coast (Cote D’lvoire)JamaicaJapanJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlands AntillesNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandThe BahamasThe GambiaTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands (British)Virgin Islands (United States)Wallis and FutunaWestern SaharaYemenZambiaZimbabweWhat type of visa do you currently hold?*Please choose oneSubclass 500 Student VisaSubclass 485 Graduate visaOther (Please specify)Type of visa - OtherPhone Number*Email Address*Suburb*Post Code/ZIP Code*Type of current/latest education*Please choose oneDiplomaBachelorMasterGraduateName of current/latest education institution*Current/latest course name*Started year*Graduation year*Why do you want to join VicWISE?*How did you hear about VicWISE?*Please choose oneLinkedInFacebookTwitterInstagramWord of MouthOther (Please specify)How did you hear about VicWISE - OtherSeparatorTerms & Conditions*.*.I have read and agree with the terms and conditions of VicWISEPassword*Submit Error occured. Please confirm your data and submit again: