Student Contact Details Form

Student Contact Details Form

Note that you only need to fill in this form if you have changed your residential details
Have you changed your residential address?*

YesNo
Course Code
Course Name
Campus*
Student ID*
Contact Details in Australia
Name*

PrefixFirst NameLast Name
Gender*

MaleFemaleOther
Address*

Street Address

Street Address Line 2

CityState / Province

Post Code
Phone Number
Email*
Emergency Contact Details in Australia
Name*

PrefixFirst NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Post Code
Phone Number*
Email
example@example.com
Relation
Privacy Statement

Personal information is collected solely for the purpose of operating as a Registered Training Organisation under the VET Quality Framework administered by the Australian Skills Quality Authority who are the registering authority the requirements of the registering authority may mean the release of your personal information for the purposes of audit, or for collection of data by Commonwealth and State Government departments and agencies. It is a requirement of the VET Quality Framework that students can access personal information held by the Institute and may request corrections to information that is incorrect or out of date. Please apply to the RTO Manager if you wish to view your own records.
Signature*

Clear
Full Name
Date

DayMonthYear
Date
Student Contact Details Form | V2 - Revised June 2020

ABN: 63 604 422 853
Should be Empty: