Predicted Results Form
International school leaver applicants Medicine/Dentistry/Pharmacy/Podiatry 

NOTE FOR APPLICANTS
•	This form is required if you will not receive your secondary school final results by the application closing date.
•	This form authorises your school to send an indication of your academic performance directly to UWA’s Admissions team.
•	If you are able to submit your final school results with your application you do not need to submit this form.
•	Applicants who will not receive their final result during the course offer period may receive an Assured Pathway conditional offer with the condition that their actual result is close to or higher than their predicted result.
•	A clear scan of the completed form must be submitted by the relevant application closing date to UWA’s Admissions Team with your application or via email admissions@uwa.edu.au:

APPLICANT’S PERSONAL DETAILS	
Given Names:	     		
Family Name:	     		
Date of Birth:	     		
ISAT ID Number:
(required for Medicine or Dentistry applicants)	     		
Email address:	     		

AUTHORISATION	
This section is to authorise your school to provide information to UWA regarding your predicted academic result. 

Signature of Applicant:	Date:      	

Signature of Parent/Guardian:	Date:      	

Examples of qualifications (this is not an exhaustive list)	Min Score
Pharmacy/Podiatry	Min Score
Medicine/Dentistry	
Australian ATAR	94	98	
UWAFP (UWA College)	78	86	
WAUFP	74	85	
International Baccalaureate	35	40	
All India Senior School Certificate (CBSE)	17.5	19	
GCE or Cambridge Advanced Level Examination	14	15	
Ontario Secondary School Diploma	85	93	
For other qualifications and information about score/grade conversion please refer to:
uwa.edu.au/study/how-to-apply/international-and-overseas-qualifications

PREDICTION OF ACADEMIC PERFORMANCE – SCHOOL’S STATEMENT	

Student’s name:       
This student is currently in their final year of:

 Australian ATAR studies,  International Baccalaureate,
 UWA Foundation/UWA College, or  WAUFP	
Predicted Result:       	

 GCE or Cambridge Advanced Level Examination, or  All India Senior School Certificate (CBSE) 
and is expected to achieve the following subject grades:	
Subject	Grade	Subject	Grade	
     	     	     	     	
     	     	     	     	
     	     	     	     	

 Canadian secondary schooling in (province): ..................................................................................... 
 Other qualification (please specify): ....................................................................................................
and is expected to achieve the following subject scores:	
Subject	Score	Subject	Score	
     	     	     	     	
     	     	     	     	
     	     	     	     	
     	     	     	     	
     	     	     	     	
     	     	     	     	

SCHOOL VERIFICATION	

School
Stamp
Here*

To be signed & stamped* by the school principal or their authorised representative

School Name      	

Signature:	     	Date:      	
*Signature sufficient if school does not have an official stamp
Submit this form with your online UWA application by the relevant due date
Or via email admissions@uwa.edu.au