APPLICANT DETAILS
Home University/Institution
Student title
Student name
Student email
Date of Birth (dd/mm/yyyy)
/ /
Study Type
Undergraduate
Postgraduate
Exchange Program (non-tuition paying)
6 months 12 months
Commencing Studies
Study Period 1 (Feb-Jun) Study Period 2 (Jul-Nov)
Commencing Studies Year
Campus Location
Cairns Townsville
DECLARATION
I declare that above named student has been approved to undertake studies at James Cook University within the
framework of our institutional Exchange agreement.
Authrorised representative of Exchange
Program Signature
Authrorised representative of Exchange
Program printed Name and Surname
Date (dd/mm/yyyy)
/ /
Returning this form to JCU
Email the completed form to
globalmobility@jcu.edu.au.
INSTITUTION STAMP
jcu.edu.au/international
CRICOS PROVIDER CODE: 000117J
Exchange Program
Letter of Nomination
click to sign
signature
click to edit
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