Change of Personal Details Form

Change of Personal Details Form
Student Number
Course
Title

Mr.Ms.Mrs.MissOther
Name

Given NameFamily Name
Change of Address

New permanent home residential address
Address
Suburb
Postcode
Home Phone Number (03)
Mobile Number
Email Address
New Mailing Address (This Is Where Windsor Will Send Any Hardcopy Correspondence)
Is your mailing address same as your residential address?

YesNo (If no, please fill the Mailing Address below)
Address
Suburb
Postcode
Emergency Contact
Name of emergency contact
Relationship with you
Address
Suburb
Postcode
Phone Number
Change of Name

Students who wish to change their name on college records should attach appropriate supporting documentation, such as a certified copy of a birth certificate or marriage certificate.
Title

Mr.Ms.Mrs.MissOther
Name

First NameFamily Name
Declaration

I hereby declare that all the information given on this form is complete and correct in all respects.
Signature

Clear
Email*
example@example.com
Date

MonthDayYear
Date
Should this document be returned by email in typed format, with all information given it will be deemed as being signed by the applicant.
Should be Empty:

Change of Address