Fillable Academic Verification Request Form Current & Past Student

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Academic Verification Request Form Current & Past Student

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Swinburne University of Technology
Academic Verification Request Form
– Current & Past Student
Doc: Academic Verification Request Form
Version 2.0 JUNE 2017
Page 1 of 2
Academic Verification
The Academic Verification is for use by external companies/agencies to confirm that the information a student has provided to them is
correct. This can be used for employment or further study. It contains the following information:
Current enrolment dates & course
Industry Based Learning
Completion dates
Conferral/Graduation dates
Any external company/agency requiring confirmation on a current or past student can apply for verification. For any information other
than conferral/graduation date, a Privacy Waiver must be supplied where the student is authorizing the release of information to the
specified company/agency.
There is no charge for Academic Verification Requests. A request generally takes between 5 to 10 working days.
Fields marked with are mandatory
Important Information
1. Verification of a student's qualification will be made where the award has been conferred/ graduated. Past students'
conferral date and award name can be released as a matter of public record.
2. All other requests will be released only with the written consent of the student.
3. If we cannot authenticate your company details or the student's permission we will decline your request.
Note: A student may have met the award requirements and not be conferred (graduation is not compulsory). Verification in
this instance cannot be provided until the student has applied to graduate.
Privacy Waiver
Companies requiring information other than the graduation date will need to provide us with a privacy waiver signed by the
student. If a student has provided a signed privacy waiver to the external body other details can be included, such as, course
completion dates, majors/minors.
Download the Privacy Waiver Form
Processing time
Processing of requests generally takes 5 working days. Verification for past students conferred prior to 2001 may take up to
10 working days.
Your Details
Organisation
Contact Name
Email
Telephone
Purpose of verification
Please select...
If other, please specify:
Student's Details
Surname:
First Name:
Date of Birth: (dd/mm/yyyy)
Qualification awarded/course enrolled:
Please select...
Swinburne University of Technology
Academic Verification Request Form
– Current & Past Student
Doc: Academic Verification Request Form
Version 2.0 JUNE 2017
Page 2 of 2
Information Required
Other Information: Please select at least one option
Graduation date Award Approval date
Major/ minor studies (if applicable)
Industry Based Learning (IBL) (if applicable)
Honours / Merits Level (applicable for Engineering programs only)
Proof of current study
Academic Transcript (applicable to past student) Other information
Please specify:
Additional Comments:
Note: All requests must be accompanied by a signed Privacy Waive
r
from the student.
Malaysian Government agencies may be excluded from the privacy waiver.
Please tick the box if you are submitting this request on behalf of a Malaysian Government agency.
I agree to the privacy disclaimer stated above.
Signature : ……………
……………………………………………………………………….
Name: …………………………………………………………………………………….
Position Title : ………..…………………………………………………………………………...
Date: ………..…………………………………………………………………………...
Privacy Disclaimer
Swinburne University of Technology collects, uses and destroys your information in accordance with our Privacy Policy.
Kindly submit via email or hand in this form and relevant documentation to:
Student Information Centre
or email to:
sic@swinburne.edu.my / verifications@swinburne.edu.my
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Academic Verification Request Form Current & Past Student

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Completed 7 August 2020

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