COURSE / CAMPUS TRANSFER STUDENT ID NUMBER

APPLICATION FORM DEAKIN UNIVERSITY

SECTION 1: PERSONAL DETAILS EFFECTIVE DATE OF TRANSFER

TITLE FAMILY NAME TRIMESTER /SEMESTER YEAR

GIVEN NAMES

SECTION 2: DETAILS OF THE PROPOSED NEW COURSE (To be completed by Student) (COMPLETED BY FACULTY COURSE ADVISER)

COURSE CODE COURSE TITLE CAMPUS

Select campus from list

MAJOR SEQUENCE

NEW FEE ARRANGEMENT

COMMONWEALTH SUPPORTED PLACE (CSP) * AUSTRALIAN FEE PAYING * INTERNATIONAL FEE PAYING

* Students may be eligible for HECS-HELP or FEE-HELP if they meet eligibility requirements (see studyassist.gov.au)

SECTION 3: APPROVED COURSE TRANSFER DETAILS (To be completed by Faculty Course Adviser) (COMPLETED BY FACULTY

CHANGE OF: COURSE CODE MODE ONLY CAMPUS ONLY VERSION

(complete all sections) (Do not complete Sections (Do not complete Sections (Do not complete Sections
5/6/7/8 or 9) 5/6/7/8 or 9) 5/6/7/8 or 9)

27/10/2015
CURRENT COURSE NEW COURSE

COURSE CODE COURSE CODE

COURSE NAME COURSE NAME

CAMPUS MODE CAMPUS MODE

* Select campus code * Select mode * Select campus code * Select mode

CORRESPONDENCE CATEGORY CORRESPONDENCE CATEGORY

EXAM LOCATION
FEE DOMESTIC DOMESTIC
ARRANGEMENT CSP FEE PAYING
*EXPECTED COMPLETION DATE *NUMBER OF UNITS
INTERNATIONAL TO COMPLETE
FEE PAYING TRI/SEM _______ 20______

FEE DOMESTIC CSP DOMESTIC

ARRANGEMENT FEE PAYING
INTERNATIONAL
FEE PAYING

SECTION 4: INTERNATIONAL STUDENTS ONLY (To be completed by Student) (CO

If you are not applying for or updating your student visa via the Department If you are a sponsored student requiring a new
of Immigration and Border Protection (DIBP) Melbourne Office, please advise Financial Guarantee for this, please tick this box.
which DIBP office is required on your CoE.

SECTION 5: CREDIT FOR PRIOR LEARNING (To be completed by Faculty Course Adviser)
Indicate if all Credit for Prior Learning under current course is to be transferred: If no, list the Credit for Prior YES NO
Learning that is to be transferred to the new course. Any new Credit for Prior Learning must be submitted on
an Application for Credit for Prior Learning form.
SPECIFIED CREDIT FOR PRIOR LEARNING UNSPECIFIED CREDIT FOR PRIOR LEARNING
UNIT CODE UNIT NAME UNIT LEVEL NO. OF CREDIT POINTS
SECTION 6: TRANSFER OF CURRENTLY ENROLLED UNITS (To be completed in consultation with Faculty Course Adviser)
ENROLLED UNITS: Indicate if all enrolled units under current course are to be transferred: YES NO
If no, list the enrolled units from the current course which are to be transferred to the new course.

UNIT CODE CAMPUS UNIT NAME TRI/SEM/YEAR CLASS CREDIT POINTS

SECTION 7: TRANSFER OF COMPLETED UNITS (To be completed in consultation with Faculty Course Adviser)
COMPLETED UNITS: Indicate if all completed units are to be transferred from the current course: YES NO
If no, list the completed units from the current course which are to be transferred to the new course.
UNIT CODE CAMPUS UNIT NAME TRI/SEM/YEAR CLASS CREDIT POINTS

SECTION 8: NEW ENROLMENT DETAILS (To be completed by Student) (COMPLETED BY STUDENT)

List only new units to be added to your current enrolment other than those being transferred from your previous course.

UNIT CODE CAMPUS UNIT NAME TRI/SEM/YEAR CLASS CREDIT POINTS

SECTION 9: PERSONAL STATEMENT (To be completed by Student) (COMPLETED BY FACULTY COURSE ADVISER)

In the event that several applicants are deemed to be equally worthy of selection on academic grounds, the Faculty may decide between applicants on
the basis of demonstrated motivation for undertaking the course. If there is anything you would like to make the Faculty aware of in support of your
application, please state your reasons for transferring below.

SECTION 10: FINAL CHECKLIST (To be completed by Student)

Use this checklist to ensure that you have completed ALL the steps necessary for your application. Your application may not be considered if it is
incomplete.
Tick if you have provided a personal statement

Tick if you have completed ALL relevant sections of this form

Tick if you have signed the Declaration.

SECTION 11: DECLARATION (To be completed by Student)

1 I have read the relevant course information provided including course structure and requirements.
2 I acknowledge I have a responsibility to seek course advice prior to varying my enrolment or re-enrolment.
3 I agree to pay all fees and charges arising from this enrolment.
4 I acknowledge that while I am enrolled, I am subject to the legislation, policies and procedures of Deakin University.
5 I declare that the information supplied by me is complete and correct.
6 I consent to the University corresponding with me by electronic means.
7 I understand by completing and submitting this form, that if my application is successful I will be automatically enrolled into the course I have requested a transfer to.
INTERNATIONAL STUDENTS
8 I understand that by signing this form, I accept the conditions of the new course as outlined in the handbook.
9 An offer with details of your new course and a new CoE will be sent to your Deakin student email account after you have submitted the required documentation to
finalise your course transfer.
10 Information on the Refund policy can be found at Withdrawal dates and penalties.

SIGNATURE DATE
- - -
_____ / _____ / _____

SECTION 12: FACULTY COURSE ADVISER APPROVAL (To be completed by Faculty Course Adviser)
I have checked all sections of this form and authorise for DSA to process.

FACULTY APPROVAL OF TRANSFER FOR COMBINED COURSES ONLY

COURSE ADVISER NAME COURSE ADVISER NAME

(NEW COURSE) (NEW COURSE)

SIGNATURE SIGNATURE

PHONE DATE - - PHONE DATE

- - - -
____ / ____ / ____ ____ / ____ / ____