Fillable Printable Student Identity Card Application Form - Australia
Fillable Printable Student Identity Card Application Form - Australia
Student Identity Card Application Form - Australia
CRICOS Provider Code 00301J (WA) 02637B
(NSW)
Application for Student ID card – External
students
Please complete this form and return with a passport sized photo (see photo specifications)
to:
Student Service
Centre
Student
Central
GPO Box
U1987
Perth WA
6845
Personal
Details
Curtin Student
ID:
Phone:
Family
Name:
Given
Name/s:
Address:
Proof of
Identity
I have provided one of the following forms of primary documentation or two of the secondary documentation
in
order for the witness to verify my
identity.
Primary Documentation
(1 required – please check
box)
Passport
or
Australian Driver’s Licence
or
National Identity
card
Secondary Documentation (
2 required - only if Primary documentation is not available. Please check
box
)
Medicare
card
Bank card (credit/debit or
EFTPOS)
Birth
certificate/extract
Marriage
certificate
Payment summary/group
certificate
Citizenship
certificate
ID Card issued by another educational
institution
Health Care, Social Security or Pension
card
Public Service employee ID
card
Other licence issued under Australian Law (e.g. Boat,
Pilot)
Private Health Insurance card (e.g. Medibank Private, HBF)
Divorce
Decree
Utilities bill (e.g. Electricity,
Gas)
Declaration
I declare that the information on this form is true and correct and I have documentation to verify if
required.
Signature:
Date:
Proof of
Identity
I declare that the photograph I have signed is a photograph of the person whose name and signature appears
on
this form. I have sighted one form of primary documentation or two of the secondary documentation as
listed
below.
Name of
Witness:
Signature of
Witness:
Profession or Occupation of
Witness:
Phone
Number:
Date:
CRICOS Provider Code 00301J (WA) 02637B
(NSW)
Application for Student ID card – External
students
Witness
Requirements
The Proof of Identity section must be completed by a person in one of the categories listed below. This
person
must also sign the back of your
photograph.
•
a Justice of the
Peace
•
a registered medical
practitioner
•
a police
officer
•
a
dentist
•
a
pharmacist
•
a solicitor or
barrister
•
a manager of a post
officer
Photo
Specifications
Your enclosed photo must meet the following
requirements:
•
no more than 6 months
old
•
in
colour
•
a full front view of your head and
shoulders
•
at least 40mm x
30mm
•
no head gear (i.e. hats, sunglasses
etc)
•
student number and witness signature on the back of the
photo
Please note: scanned, black and white, family photos etc will not be accepted. Your application will
be
returned to you and you will be required to re-submit a new application with a photo that that meets
these
requirements.
Information about your new Curtin ID
card
Your Curtin ID card has a number of functions. First and foremost it contains your personal information
and
photograph. On campus it is used for access to a variety of buildings including Abacus Labs, print services
and
Library facilities. Your card also has a Curtin sticker which verifies your enrolment for the year ahead. You
must
always have your Curtin ID card when sitting
Examinations.
Your first student card is free. If your card is lost a replacement fee will be incurred. Stolen cards will be
replaced
free of charge, only in the instance where a police report number is submitted. Damaged cards will only
be
replaced free of charge in the instance that the damaged card is returned to the Student Service
Centre.
For more information regarding your Curtin ID card please
visit:
http://students.curtin.edu.au/administration/id_cards.cfm
Don’t
forget!
As an enrolled student at Curtin, it is a condition of your enrolment that you access OASIS at least once a
week.
OASIS – Online Access to Student Information
Services
•
OASIS is Curtin’s student portal. Through OASIS students are
provided
with access to their student record (eStudent), the
Official
Communications Channel (OCC) and a range of other online
services
including a student email account and learning support
systems.
•
It is a condition of enrolment at Curtin that students activate their
OASIS
account and access OASIS at least once a week to receive
official
communications from the University via the
OCC.
•
Students may be granted exemption from the requirement to
access
OASIS in exceptional circumstances
only.
PRIVACY
STATEMENT
At Curtin, the privacy of students, staff and other people who the University deals with is taken very seriously. Much of the information
which the University collects in connection with its normal functions and activities is "personal information", and this information
is
handled in accordance with relevant privacy standards. For details of how the University will use, disclose and protect your personal
information please refer to http://global.curtin.edu.au/legal/privacy.cfm
