The University Of Newcastle Change Of Details Form
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1
2Change of Details Form
Request to change:
Preferred
Name
DOB
Gender
(Please tick one or
:
:
:
Name:
more)
CURRENT DETAILS
Student Number:
Date of Birth
Family Name:
Other Name(s):
Prefix :
Mr/Mrs/Miss/Dr etc.
Gender:
Male:
Female:
Indeterminate/Intersex/Unspecified:
DETAILS TO BE UPDATED (PLEASE ADD CHANGED DETAILS)
Student Number:
Date of Birth
Family Name:
Other Name(s):
Prefix :
Mr/Mrs/Miss/Dr etc.
Gender:
Male:
Female:
Indeterminate/Intersex/Unspecified:
THE FOLLOWING DOCUMENTATION IS REQUIRED
Please provide CERTIFIED COPIES (see over page), or submit documents to any Student Hub for certification
Change of Name
(2 of the below, one showing previous name
Date of Birth
Gender
and one showing new name)
Birth Certificate
Passport
Doctor / Psychologist Certificate OR
Passport
Birth Certificate
Passport
Marriage Certificate
Deed Poll
Licence
Deed Poll
Student Signature:
Date:
Please return application form with documentation to:
Enrolments, HG10 - Hunter Building,
University of Newcastle
CALLAGHAN, NSW, 2308 AUSTRALIA
Phone: +61 2 4921 5000 E-mail:
name-changes@newcastle.edu.au
Fax: +61 2 4921 2020
Research Scholarship holders must also email
ResearchScholarships@newcastle.edu.au
to notify change of details.
ENROLMENTS USE ONLY
Documentary evidence sighted (and attached)
Details changed by: ____________________
Date: ___________________
Completed forms and their attachments will be retained as required by the University of Newcastle RECORDS MANAGEMENT POLICY - 000285
Enrolments
Student Central
Updated January 2016
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