Notification of Change of

Citizenship/Visa
PLEASE REFER TO THE BACK OF THIS FORM FOR INSTRUCTIONS AND INFORMATION
Student ID

Date of Birth

Title (please circle)

Mr

Ms

Miss

Mrs

Surname/Family Name

_______________________________

Dr

dd/mm/yy

Other (specify)
Given/Other Names

Address
Contact Phone No.
Previous Citizenship/Visa Status (please tick relevant box)

________________________________________

New Citizenship/Visa Status (please tick relevant box & attach appropriate evidence)

Australian Temporary (including Student) or Provisional Visa Holder

Australian Permanent Resident
New Zealand Citizen
Other (please specify)

Australian Permanent Resident

Australian Citizen
New Zealand Citizen
Protection Visa (e.g. Special Humanitarian/Refugee Status
Other Visa (including cancellation of citizenship/visa type: (please specify)

Important Details (please complete relevant sections)

Date of effect / issue Citizenship / Visa
Passport Details
Holders Name as printed in passport (family name first)

Visa Subclass (3 digits)

Date of Birth as printed in passport

Country of Citizenship

Passport Number

Expiry Date

Student Declaration
I declare that the information provided is true and correct. I understand that acceptance of this form does not guarantee that my
entitlements will alter, and I will be advised of the outcome, which is subject to Commonwealth Immigration Law and Visa requirements.
Student Signature

Date

The University of Melbourne collects personal information in accordance with the University Privacy Policy which can be viewed in full at
http://www.unimelb.edu.au/unisec/privacy/studentinfo.html Information is collected, used and stored for the purpose of administering enrolment and related activities.
Commonwealth and State agencies require certain information to be reported or disclosed by the University. You may request access to your information at any time by
contacting the privacy officer at privacy-officer@unimelb.edu.au

TEAR HERE

STUDENT RECEIPT: NOTIFICATION OF CHANGE OF CITIZENSHIP / VISA FORM

Date lodged:_________________________ Student Centre Name:
Your citizenship documents will be verified and any changes will be confirmed to you in writing. Please allow up to two weeks for processing. Please
direct all enquiries to Student Administration on +61 3 83444772 or email sa-can@unimelb.edu.au
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Further Information
University contact details and self help information are available on the
web at http://my.unimelb.edu.au/
Australian Government information, regarding HECS-HELP and
FEE-HELP, is available on the web at http://studyassist.gov.au/

INSTRUCTIONS TO STUDENTS
This notification is used to declare a change to your citizenship/visa status. The University requires you to notify us of any changes in your citizenship/visa status
as they may affect your payable tuition fees and/or study entitlements. Any changes will affect subjects after their next census date
Please complete and sign this form
1.
2.
3.

Provide all required documentation, see below

Lodge the completed form at your Student Centre/ at Student Administration EMS/ or by post
Allow up to two weeks for processing. You will be notified of the outcome in writing

Type of documentation required:

Australian Citizenship

Australian passport, or Evidence of Australian Citizenship (as awarded in a Citizenship

Ceremony)

New Zealand Citizenship

New Zealand passport

Australian Permanent Visa or Australian Protection Visa

Visa Label endorsed in passport and passport photo page or Electronic-Visa (e-visa)
and passport photo page

Other Visas Student/Temporary/Bridging

Visa Label endorsed in passport, Electronic-Visa (e-visa) or a copy of your letter from
the Department of Immigration & Citizenship (DIAC) notifying of visa grant

Cancelled Citizenship/Visa

A copy of your letter from the Department of Immigration & Citizenship (DIAC) notifying you of cancelled Citizenship / Visa,
documents relating to any official appeal(s) lodged, and new Citizenship/Visa granted (if applicable)

How to provide documentation:

1. If you have received an offer of an international place and you have been granted Australian Permanent Residency, take this notification form and required
documentation to the International Admissions in the Information Centre, Richard Berry building.
2. If you are a current student lodge the notification with your Student Centre or Student Services, Ground Floor Baldwin Spencer Building. Take this form plus
all original documents or certified copies for sighting and copying by University staff
3. Or mail this notification form with certified copies of related documents to Student Administration, Level 1, Raymond Priestley Building, Parkville 3010

INSTRUCTIONS FOR STUDENT CENTRE STAFF

1. Identify the student (e.g. sight their student card, passport, etc.)
2. Check that the student has signed the form, completed relevant fields, and provided all related documentation
3. Complete Student Centre Use Only fields below, noting date of lodgment
4. Prepare the top of the form (overleaf) and related documents for forwarding to Student Administration
5. Complete Student Receipt section and give to student
6. Forward the top of the form (overleaf) and related documents to Student Administration Do not make any changes in ISIS.

OFFICE USE ONLY

Student Centre Use Only
Student Centre Name:
Staff Member Name:

Date Lodged
No. of Pages (incl this Notification)

Date Notification Form & related documents forwarded to Student Administration :

STUDENT ADMIN USE ONLY
Date Received:
Action Taken:

Date Actioned:
Staff Member Name:

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