7/29/2019 Application Form Credit

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Family name:

Name:

Title:

Given names:

Preferred name:

University of Sydney student number:

(i.e. not an Australian citizen, Permanent resident or New Zealand citizen)

IfYes, you should only lodge an application form if you are applying

for credit for prior study at the University of Sydney Summer School.

A. PERSONAL DETAILS (please print)

Session Mailing Address*:

Street:

Suburb/Town:

State: Postcode:

B. CONTACT DETAILS (please print)

University Email Address:

Telephone*:

Mobile:

Work:

Home:

Facsimile:

Date of Birth:

UG/PG

APPLICATION

Credit for Prior Tertiary Study

Gender:

C. CURRENT UNIVERSITY OF SYDNEY AWARD COURSE DETAILS (please print)

University of Sydney award course:

Degree/Course:

Major 1:

Proposed Major(s) (if applicable):

Award level (Undergraduate/Postgraduate):

Page 1 of 2

Country

Major 2:

UG/PG CrA 060512

Are you an international student? (tick box)

Yes

No

*The response to your application will be mailed to you and we may need contact you by

phone to confirm details of your application, therefore please provide an address in or

close to the Sydney area and, if possible, a mobile phone number

Faculty of Science

7/29/2019 Application Form Credit

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Prior award course:

D. REQUEST FOR CREDIT (please print)

Did you complete the degree?

University:

Degree/Course:

Award level (Undergraduate/Postgraduate):

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Units undertaken for which credit is requested:

Y / N

eg GEOG101 Introduction to Physical Geography 1997 10 GEOG

Grant

creditSpecified

Unit code

Unspecified

Area cp

Unit name Subject

area

Credit recommendation

FACULTY OF SCIENCE USE ONLY

Initials/Date

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Y / N

Precedent

Level

Attach separate sheet if insufficient space.

Unit code Year Credit points

or hrs/week

Date:Signature:

Declaration:

I declare that I have read the Credit for Prior Tertiary Study Information sheet, that the information supplied on this form is correct and complete,

and authorise the Faculty of Science to obtain further information with respect to my application.

Copies of detailed descriptions of prior units of study completed, as at the time of completion of the units.

Official certified academic transcript for all tertiary-level studies for which credit is requested.

Signed and dated Credit for Prior Study application form with all required fields completed.

To ensure that your application is processed as quickly as possible, tick each box when each supporting document has been completed or

attached:

Complete and print this application form and submit, with supporting documents, to the Faculty of Science Student Information Office, Level 2,

Carslaw Building, University of Sydney, NSW, 2006, AUSTRALIA.

E. SUBMISSION OF APPLICATIONS

UG/PG CrA 060512