CIT Student Number (5 digit number)

    USQ Student Number

    Family Name

    Given Name/s

    Program Enrolled

    Date of Birth

    New Address

    Street Address

    Suburb

    Postcode

    Contact Details

    Mobile Phone Number

    Email Address

    USQ Sydney collects personal information to assist the University in providing tertiary education and related ancillary services and to be able to contact you regarding enrolment, assessment and associated USQ services. The information may be made available to Commonwealth and State agencies and the Tuition Protection Service Director and Secretary pursuant to obligations under the Education Services for Overseas Student Act 2000 and National Code or other legislative requirements. Personal information will not be disclosed to third parties other than to a USQ approved agent, partner or any organisation who provides sponsorship to you for your studies, without your consent unless required by law.

    Student Signature

    Date

    In addition to completing this form you are also required to update your contact details in Uconnect. Log into Uconnect, go to Student Centre, Personal Details Tile, Contact Details menu item.