Student Change of Details Form Student Change of Details I am a student of International College of Melbourne and wish to advise a change of: Name (please provide proof of change of name) Home Address Contact Details Other Employer / WorkplaceCurrent Course:Student Name (as on current records):Date of Birth: DD slash MM slash YYYY Current Course:Please provide latest information belowSurname :First Name :Middel Name :Home Address:Phone:Fax :Mobile :Email :Workplace/ Employer (workplace-based courses):SignatureDate DD slash MM slash YYYY Organisation Change of Details I am an organisation/ client/ employer of a student of International College of Melbourne and wish to advise a change of: Company or Business Name Business or Postal Address Contact Details Contact Person OtherOtherPlease provide latest information belowBusiness Name:Contact Person:Position:Business and/or Postal Address:Phone:Fax :Mobile :Email :SignatureDate DD slash MM slash YYYY Please return this completed form to International College of Melbourne, ICM admission teamEmail: [email protected]