Section 1 - Personal Data
Date of Birth: *
Date of Birth:
Address: *
Contact Number: *
Contact Number:
Section 2 - Unit Enrolment Information
Student Declaration:
Checkbox *
• I understand it is my responsibility to ensure that my enrolment is correct. • I have sought appropriate academic counseling in relation to my enrolment. • I agree to be bound by the Statutes, rules and Policies of the University as amended from time to time and agree to pay all fees, levies and charges directly arising from my enrolment. • I agree to receiving information electronically from the University. • I agree to access OASIS (student portal) at least once a week to receive official communications from the University (unless approval for exemption is granted). • I am aware of the conditions under which I am permitted to use University IT (computer) facilities. • I acknowledge that I have read and understood the University’s Privacy Statement. • I acknowledge that any expenses, cost or disbursement incurred by the University in recovering any monies owing by me shall be the responsibility of the debtor, including debt collection agency fees and solicitor’s costs on the amount outstanding and all other reasonable costs incurred in the recovery of outstanding monies.
Privacy Statement
At Curtin University, the privacy of our students, staff and the people we deal with is very important to us. Much of the information that the University collects in order to provide the service that it does is “personal information”. For details of how the University will use, disclose and protect your personal information, please refer to
Signature: *
Date: *