Unsw Correction Or Change Of Personal Details Request Page 2
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2CORRECTION OR CHANGE OF PERSONAL DETAILS REQUEST
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Student Life and Learning
Student Central
SECTION 3:CORRECTION OF OR CHANGE OF NAME
DETAILS OF PREVIOUS INCOMPLETE OR INCORRECT NAME:
Family Name
First Name
Middle Name
DETAILS OF NEW NAME:
Family Name
First Name
Middle Name
TITLE:
Mr
Miss
Mrs
Ms
Dr
Other
Are you graduating from your UNSW degree or award within the next 6 months
YES
NO
Are you submitting any other documents with this form? Please specify
Documents must be received no later than the deadline indicated in the conferral email from the Graduations Office
Please indicate the date of your scheduled graduation
/
/
(dd/mm/yyyy)
ORDER OF YOUR NAME FOR YOUR TESTAMUR (DEGREE CERTIFICATE)
SECTION 4A:CORRECTION OF DATE OF BIRTH
If your date of birth has been incorrectly recorded on UNSW records, please indicate your correct date of birth below:
/
/
(dd/mm/yyyy)
Correct Date of Birth
FOR OFFICE USE ONLY:
Date of Birth recorded on NSS before change mode
/
/
Initials
SECTION 4B:CORRECTION OF GENDER
If you have changed your gender or your gender has been incorrectly recorded on UNSW records, please indicate below:
Correct Gender
Intersex,Indeterminate or Unspecified
Male
Female
SECTION 5:DECLARATION
I have read and understood the guidelines and advice on this application form. I certify that all information, including supporting
documentation and certificates are correct.
/
/
Student ID
Signature
Date
(dd/mm/yyyy)
FOR OFFICE USE ONLY:
YES
NO
Has deadline passed to change name for graduation?
Ceremony date & no.
Graduations emailed?
YES
NO
Documentary evidence type:
BC
PP
MC
Other
Other comments:
Date:
Initials:
CRICOS Provider Code 00098G
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