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Graduate Diploma of Midwifery essential requirements

Note: This is an ‘essential requirements’ form. Please ensure that you have also met all other application requirements for this program, including submission of your direct application.

* indicates required field

Application details


(if known)
If accepted into this program I intend to study... *

Personal details

Date of birth *

Placement details

Placement type * Please select the relevant option.

Please complete the appropriate checklist below

I am a registered nurse, and I have/will include/d the following documents with my application * Each component must be supplied before your application will be assessed. If this checklist is not relevant to you please select N/A and complete the next checklist


I am a registered midwife upgrading my qualification, and I have included the following documents with my application * Each component must be supplied before your application will be assessed. If this checklist is not relevant to you please select N/A and complete the previous checklist

You may upload your supporting documents here. (Maximum file size is 5 MB.) Alternatively they can be attached to your direct application or emailed to admissions@federation.edu.au.

*Refer to Immunisation status form and Health Vic Guidelines

Clinical referee details

Include the names and contact details of two nominated clinical referees, one referee must be your current or most recent manager. Please ensure contact details are correct and current.

Referee 1: Current or most recent manager



Referee 2



Privacy statement

The information being sought in this form is collected for the purpose of processing your application, and, if your application is successful, delivering a program of study to you.

The information gathered in this form, and in any subsequent selection interviews or referee checks, will be used by the University to determine your eligibility and suitability for admission into the program. The information may be disclosed to organisations outside the University, including the Education Department, nominated referees etc, in line with the information provided in this form. If this information is not provided, the University may be unable to process your application. You have a right of access to, and correction of, your personal information in accordance with the University’s information Privacy Policy. You may also contact the University’s Privacy Officer at privacy@federation.edu.au

Applicant declaration

You must agree to all statements to complete your application *