Associate member program for new members - Emmanuel College

New Associate Member Application

Applications close 31 January 2022.

I would like to apply for:

2022 Full year - $ 2,0002022 Semester 1 - $ 1,1002022 Semester 2 - $ 1,100Orientation Week (beginning of semester 1 only) - $ 600UQ Sport Lifestyle Package - $240

Applicant's details

First name (required)

Last name (required)

Date of birth (required)

Gender (required)

Town and country of birth (required)

Nationality (required)

Present residential address (required)

State (required)

Postcode (required)

Mobile number (required)

Email address (required)

Parent/Guardian details

First name (required)

Last name (required)

Telephone

Mobile number (required)

Present residential address (required)

State (required)

Postcode (required)

Email address (required)

Accounts email (if different to personal)

Account payer contact details

First name (required)

Last name (required)

Telephone

Mobile number (required)

Relationship to applicant (required)

Present residential address (required)

State (required)

Postcode (required)

Email address (required)

Applicant’s intended degree of study

Degree (e.g. B Arts) (required)

UQ student number (if known)

Secondary education

School (required)

Years attended (e.g. 2014-2017) (required)

Community/school roles, interests and sports (indicate level of interest and participation) (required)

OP/ATAR (if known)

Photograph

Please upload a portrait style image of yourself. This will remain on your records whilst you are an associate member.

Proof of age

Please upload a copy of your proof of age (birth certificate, drivers licence or passport).