Change of Personal Details Form

First Name *

Surname *

Mobile Number *

Email Address *

Date of Birth *

Student ID

Type of change

Previous Full Name *

New Full Name *

Supporting Documentation *

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Please attach JP Certified copies of any legal documentation associated with your change of name (ie. Marriage Certificate, Deed Poll, etc.)

Residential Address

Postal Address

Home Phone Number

Email Address

New Residential Address *Address Line 1

Address Line 2

City

State / Province / Region

Postcode

Country

New Postal Address *Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

New Home Phone Number *

New Email Address *

I declare the information provided is true and correct and authorise College Australia to change my details *

Signature *

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CRICOS PROVIDER: 03513F | RTO NO. 31222

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