Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

Application declaration form

On-campus undergraduate and postgraduate studies

All applicants to Deakin University, Australia, must sign a declaration declaring that the contents
of their application are correct and complete. If you have applied to Deakin through an agent
representative’s application portal, please submit a signed copy of this form with your application.

E0#/75&/$8#;

Privacy statement
!"#$%#&'#$(&)*#&+,"",-./0&1#$2./&3/.4#'%.)5&6'.4$75&%)$)#8#/)&-.)*&'#0$'(&),&$/5&./+,'8$9,/&5,:&6',4.(#&),&
1#$2./&$%&6$')&,+&)*#&$66".7$9,/&6',7#%%;
1#$2./&3/.4#'%.)5&.%&7,""#79/0&5,:'&6#'%,/$"&./+,'8$9,/&+,'&)*#&6'.8$'5&6:'6,%#&,+&$%%#%%./0&5,:'&$66".7$9,/<&
=*#&3/.4#'%.)5&-.""&$"%,&:%#&)*.%&./+,'8$9,/&),&'#0.%)#'&5,:&./&1#$2./>%&%):(#/)&8$/$0#8#/)&%5%)#8?&+,'&6"$//./0&
$/(&@:$".)5&$%%:'$/7#&6:'6,%#%&$/(&),&/,9+5&5,:&$A,:)&+:')*#'&,66,'):/.9#%&$/(&$794.9#%&,+&1#$2./&)*$)&8$5&
A#&,+&./)#'#%)&),&5,:<&B,:'&6#'%,/$"&./+,'8$9,/&8$5&A#&%),'#(&./&C7",:(>DA$%#(&%#'4#'%&",7$)#(&./&E:%)'$".$&
,'&,4#'%#$%<&1#$2./&8$5&6',4.(#&5,:'&6#'%,/$"&./+,'8$9,/&),&'#"#4$/)&./%9):9,/%&$/(&#86",5#'%&),&4#'.+5&
5,:'&@:$".F7$9,/%&$/(&8$5&(.%7",%#&5,:'&6#'%,/$"&./+,'8$9,/&),&E:%)'$".$/&0,4#'/8#/)&$0#/7.#%?&./7":(./0&
)*#&1#6$')8#/)&,+&G,8#&EH$.'%&$/(&I,'(#'&!',)#79,/&$/(&)*#&1#6$')8#/)&,+&J(:7$9,/&$/(&='$././0?&-*#'#&
'#@:.'#(&A5&"#0.%"$9,/&,'&),&%:66,')&5,:'&4.%$&$66".7$9,/<&B,:'&6#'%,/$"&./+,'8$9,/&-.""&$"%,&A#&(.%7",%#(&),&
5,:'&,4#'%#$%&%):(#/)&*#$")*&7,4#'&6',4.(#'&$/(?&.+&5,:&$'#&:/(#'&KL&5#$'%&,+&$0#?&),&)*#&7$'#'&$66,./)#(&+,'&5,:<&
M+&$/&$0#/)&*$%&$%%.%)#(&5,:&-.)*&5,:'&$66".7$9,/&+,'&$(8.%%.,/&,'&5,:'&4.%$&$66".7$9,/?&1#$2./&$/(&)*#&$0#/)&
8$5&%*$'#&5,:'&6#'%,/$"&./+,'8$9,/<&
B,:&$'#&/,)&'#@:.'#(&),&6',4.(#&)*#&./+,'8$9,/&'#@:#%)#(?&*,-#4#'&.+&)*#&./+,'8$9,/&.%&/,)&6',4.(#(?&1#$2./&
8$5&/,)&A#&$A"#&),&$%%#%%&5,:'&$66".7$9,/<
1#$2./&8$/$0#%&6#'%,/$"&./+,'8$9,/&.)&*,"(%?&./7":(./0&'#@:#%)%&A5&./(.4.(:$"%&+,'&$77#%%&),&)*#.'&6#'%,/$"&
./+,'8$9,/?&./&$77,'($/7#&-.)*&)*#&!'.4$75&$/(&1$)$&!',)#79,/&E7)&NOKP&QR.7S&$/(&)*#&G#$")*&T#7,'(%&E7)&NOOK&
QR.7S<&1#$2./>%&!'.4$75&!,".75&8$5&A#&4.#-#(&,/&The Guide – !"#$%%&!'()*+',+'-.*/,'+),-)<
U,'&+:')*#'&./+,'8$9,/&,/&6'.4$75&$)&1#$2./&6"#$%#&7,/)$7)&+61 3 5227 8524 or email #0*1-234+'-.*/,'+),-)<

Declaration
M&(#7"$'#&)*$)&),&)*#&A#%)&,+&85&2/,-"#(0#&)*#&./+,'8$9,/&M&*$4#&%:66".#(&./&)*.%&$66".7$9,/&$/(&)*#&
(,7:8#/)$9,/&%:66,'9/0&.)&$'#&7,''#7)&$/(&7,86"#)#<&M&-.""&6',4.(#&,'.0./$"&(,7:8#/)$9,/&$%&'#@:.'#(&$/(&
$72/,-"#(0#&)*$)&)*#&6',4.%.,/&,+&./7,''#7)&./+,'8$9,/&,'&(,7:8#/)$9,/&,'&)*#&-.)**,"(./0&,+&'#"#4$/)&
./+,'8$9,/&,'&(,7:8#/)$9,/&'#"$9/0&),&)*.%&$66".7$9,/&8$5&'#%:")&./&7$/7#""$9,/&,+&$/5&,H#'&,+&#/',"8#/)&
,'&$7):$"&#/',"8#/)&A5&1#$2./&3/.4#'%.)5<&M&*$4#&'#$(&$/(&:/(#'%),,(&)*#&%#79,/%&,+&)*#&M/)#'/$9,/$"&V,:'%#&
W:.(#&'#"$9/0&),&)*#&7,:'%#%&M&*$4#&%#"#7)#(?&$/(&)*#&$(8.%%.,/&6',7#(:'#%?&+##%?&'#+:/(&6,".75&$/(&6'.4$75&
6,".7.#%<&M&:/(#')$2#&),&8$2#&98#"5&6$58#/)%&,+&$/5&+##%&,'&$%%,7.$)#(&7,%)%&+,'&-*.7*&M&$8&".$A"#<&M&$8&$-$'#&
,+&)*#&".2#"5&7,%)%&,+&85&%)$5&./&E:%)'$".$&$/(&*$4#&)*#&/#7#%%$'5&F/$/7.$"&7$6$7.)5&),&8##)&%:7*&7,%)%&+,'&)*#&
(:'$9,/&,+&85&7,:'%#<

E66".7$/)>%&%.0/$):'#; 1$)#; MAY 13, 2020

E66".7$/)>%&+:""&/$8#;
NITIKA JAIN

5607)/+'07897-##:*2-/&;$

!$'#/)[W:$'(.$/>%&+:""&/$8#; 1$)#;

1#$2./&3/.4#'%.)5&VTMVXY&!',4.(#'&V,(#&OOKKZI

You might also like