Graduation Certificate Collection Form
Please complete this form to request collection of your graduation certificate.
COLLECTION OPTIONS
Self-collection
Collect your certificate in person after arranging collection with Student Services.
Collection by an authorised representative
If someone else will collect your certificate, you must:
1. Email a written authorisation request to studentservices@lihe.edu.au.
2. Complete this form with your authorised representative's details.
Name
*
First Name
Last Name
Student ID
*
Date of Request
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Course
*
Please Select
Bachelor of Business Administration (BBA)
Graduate Diploma of Early Childhood Education
Certificate Collection Arrangement
*
Please Select
Self-collection (I will collect my certificate in person)
Collection by an authorised representative
Full name of authorised representative
*
First Name
Last Name
Declaration
*
I confirm that I have emailed Student Services the authorisation details for the person named above and have authorised them to collect my graduation certificate on my behalf.
Signature
*
Submit
Submit
Should be Empty: