Change of Detail Form

Gamma College Student ID Number*

Name*

First NameLast Name

Date of Birth *

Date

Please select which information you would like to update*

Australian Address ( "Address proof is required)Email AddressContact NumberEmergency ContactPassport Details: (New passport page is required)Visa Details: (New VISA page is required)

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Address Evidence provided & Attached

Driver's licenceBank StatementLease/Rental AgreementOther

File Upload*

New email address

example@example.com

Updated Mobile Number

Updated Home Number

Date

Emergency Contact

Contact Name

Email

example@example.com

Relationship with you

Phone Number

Address

I declare that information I have provided in the form is accurate.

Iauthorise Gamma College to examine the validity of supporting reasons and documents.

I have read and understood that I have obligations to notify the College any change relating to the contact information

Iunderstand that providing incorrect or fraudulent information may contravene Australian Laws and may then severely affect my visa.

I agree that I the College may share relevant information about me can be shared, in certain circumstances with the Australian Government and designated authorities and, if relevant, the Tuition Assurance Scheme and the ESOS Assurance Fund Manager

Signature *

Date

Student information

Changes Request

STUDENT DECLARATION