Student Contact Details Form

* Note: If you are currently living outside Australia, you do not need to complete this form.

Your details
Your Student Number*

You can check for this number on your Letter of Offer.
First Name:*
Last Name:*
Email address:*
Mobile number:*
Your Address in Australia
Address*
Street Address City State / Province / Region ZIP / Postal Code
Emergency Contact Details
Who should we call if you are sick or injured? This person must be able to make medical decisions on your behalf.
Name of contact:*
Relationship to you:*
Emergency mobile number:*
Emergency email address:*
Do you suffer from any medical conditions (eg. ashtma, diabets, epilepsy, other)?*
- No
- If yes please list in 'other'
Declaration
Please read and check that you understand the following statements:*
- I declare to the best of my knowledge the information supplied on this page is correct.
- I have read and agree to abide by the Conditions of Enrolment outlined in the Student Handbook, which includes the Centre’s Cancellation and Refund Policy and the Student Code of Conduct.
- I understand that if any of my details change, I must advise UEC in writing within 7 days of the change.

Your details