Fillable Form 2021: Research Enrolment Personal Information Check the (Macquarie University)

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Form 2021: Research Enrolment Personal Information Check the (Macquarie University)

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  • 53 check-boxes
  • 63 other fields

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Page 1 of 4
Personal
Information
Check the following details carefully. For corrections, cross out the word and PRINT the
correction clearly in pen.
2021
1.
Family Name Given Names Title Date of Birth
2.
Contact address during term. Mailing address for all correspondence.
3.
Permanent home residence address. This must not be a PO Box address.
N.B. International students must provide overseas permanent address.
4.
Business Details. If you are currently employed on a continuing basis.
Employer’s Name:
Mailing Address:
State: Postcode:
5.
Other Contact details – Telephone (essential)
Home Ph:
Work Ph:
Mobile Ph:
6.
Next of Kin or person to contact in an emergency
Name: Relation to self: Tick one
Home Ph: Parent Spouse
Mobile: Work Ph: Partner Sibling
Address: Son/Daughter Other
State: Postcode: Other
Course Information
Course/Degree Code:
Course/Degree Name:
Faculty:
Research Enrolment
Enrolment not possible until any outstanding debt is paid
Family Name:
MQ ID:
Course:
PHD MPHIL MRES Year 2
MRES Yr 1 BPHIL
(please tick relevant box)
Page 2 of 4
Enrol by Date:
NB: BPhil/MRes Yr1 and MRes Yr 2 have set start dates for Session 1 and Session 2
Full time Part time
Onsite Off-site:
Location
7. Attendance Mode
Internal
8. Field of Education (Discipline)
______________________________
9. Liability Category
Domes
tic RTP
Commonw
ealth Supported Place
Inter
national Fee Paying
10.
Completion of Program (course) requirements.
When do you expect to finish this program? Year 1
st
Half Year 2
nd
Half Year
If you expect to complete requirements for the postgraduate program for which you are enrolled
this year, you must complete the information below: If you do not complete this question no check will
be made of your record to determine whether you will qualify for an award this year.
Name of Degree/Diploma/Certificate to be awarded:
Name of major area of study in which you will have specialised:
11.
Information required of students enrolling in one or more distance education units. To encourage
contact between distance education students, and formation of study groups, the Centre for Open Education
will circulate the names, addresses and telephone numbers of distance education students to other students
in the same units. Indicate by ticking one box below.
Yes, I
agree
No, I do not
agree to my name and address appearing on these lists.
12. Citizenship and residence status
[Code 1] Australian citizen (including Australian citizens with dual citizenship)
[Code
2] New Zealand citizen or a diplomatic or consular representative of New Zealand, a member of the
staff of such a representative or the spouse or dependent relative of such a representative, excluding those
with Australian citizenship. (Note: Includes any such persons who have Permanent Residency status in
Australia.)
[Code 8] Students with Permanent Humanitarian Visa
[Code 3] Students with permanent visa other than Permanent Humanitarian visa
[Code
4] Student has a temporary entry permit or is a diplomat or a dependent of a diplomat
(except New Zealand) and resides in Australia during 2021
[Code 5] Status other than one of the above and the student is residing outside Australia during 2021
Statisti
cal Information
MQ
ID:
Surname:
Page 3 of 4
13. Residi
ng in Australia during the study period? Yes No
14. Residi
ng outside Australia due to a course requirement? Yes No
15. If you were not born in Australia, in what year did you first arrive in Australia?
If y
our course is held outside Australia, write N/A
16. What is your country of citizenship? In what country were you born?
17. Do you speak a
language other than English at your permanent home residence?
Yes No, English only
If yes, what is the name of the non-English language that is spoken most often?
18. Are y
ou of Australian Aboriginal or Torres Strait Islanders origin?
No Yes; Australian Aboriginal Yes; Torres Strait Islander Yes; Australian Aboriginal & Torres Strait Islander
19. This quest
ion applies only to the educational attainment prior to commencing this course which you are
now enrolling.
Prior to commencing this course, what was your highest level of educational attainment and the year of
attainment? (Tick ONE only)
Educati
onal Level
Tick
One
Year of
A completed Higher education postgraduate level course
A completed Higher education bachelor level course
A completed Higher education sub-degree level course
An incomplete Higher education course
A completed TAFE award course
A completed final year of secondary education course at school
or TAFE
_ _ _ _
A completed other qualification or certificate of attainment or
competence
_ _ _ _
No prior educational attainment
20. Disabi
lity, impairment or long-term medical condition
This information is
collected as a requirement of the Department of Education, Skills and Employment
and is used for statistical purposes.
Indicate any area(s) of impairment.
Hearing Vision Learning Medical Mobility Other
If you require support services based on y
our disability or health condition, please contact
Campus Wellbeing prior to the commencement of your studies.
Phone: 02 9850 7497 or Email: wellbeing@mq.edu.au
Page 4 of 4
Declarati
on
MQ ID:
Surname
:
Please read the statements below carefully.
On completion of admission at Macquarie University, you are bound by the following Terms and Conditions. All students must
comply with the requirements set out in these Terms and Conditions for the duration of their studies at Macquarie University:
You must:
1.
conduct yourself in an honest, ethical and professional manner consistent with the values of the University's
Ethics Framework;
2.
inform yourself a
nd act in accordance with the by-laws and rules, policies and codes of conduct (including the
Student Code of Conduct) of Macquarie University. The Codes of Conduct are binding on all students. The Codes
of Conduct define misconduct at the University. Misconduct may give rise to disciplinary proceedings;
3.
pay fees according to the fees rules and applicable policies; and
4.
keep your contact and next-of-kin details up to date.
You acknowledge and agree:
1. that you have read and understood Macquarie University's privacy framework and that Macquarie
University may collect, use and disclose your personal information in accordance with the applicable
privacy collection notices that form part of the privacy framework;
2. that Macquarie University may use electronic communication methods to deliver information relevant to
your studies, personal safety, and otherwise;
3. to access all information and to read your University-assigned email address at least once a week;
4. for the purpose of the SPAM Act 2003 (Cth) and any corresponding regulations, to the sending and
receiving of electronic messages;
5. that Macquarie University can publish information on any awards and prizes you have been awarded and,
where appropriate, the results for your honours program of study;
6. you are responsible for informing yourself of and complying with the requirements for your program of
study;
7. that if you enrol in units which are contrary to academic advice you are responsible for the consequences
resulting from enrolment in those units including any fees and penalties for late enrolments and/or
changing units that you are liable for should you incur them;
8. that you have read and understood the Campus Card and Your Privacy statement; and the Transport for
NSW Travel Concession and Your Privacy statement;
9. that Macquarie University reserves the right to amend tuition and/or other fees, due to changes imposed
under Australian Commonwealth or State legislation or regulation;
10. that Macquarie University may at any time vary these Terms and Conditions.
11. Macquarie University may disclose your personal information and information about your enrolment to
Australian Government and State Government Agencies, where this is required or authorised by
Australian law or NSW law. This may include Services Australia (if you are claiming or receiving a
payment from Services Australia), the Australian Taxation Office, Transport for NSW (in connection with
travel concessions offered to you), the Department of Education, Skills and Employment, the Department
of Immigration and Border Protection (DIBP) (in administering the ESOS legislation relating to your visa
or travel status), for example. Personal Information disclosed to Services Australia and other Australian
Government agencies is protected by law, including the Privacy Act 1988 (Privacy Act 1988)
12. You are still required to notify Services Australia of any change that may affect any government
payment you receive
Signature: Date:
click to sign
signature
click to edit
Page 1 of 4
MQ ID:
Assignment of Student IP to the University
T
HIS AGREEMENT is made
B
ETWEEN MACQUARIE UNIVERSITY, a statutory corporation established pursuant to the Macquarie
University Act 1989, of North Ryde, NSW 2109 (“the University”) of the one part,
AND ,
[Student’s full name]
of
[Student's home address]
(“
the Student”) of the other part.
B
ACKGROUND
A
The Student has been offered enrolment as a candidate for a postgraduate research degree at the University
and upon completion of enrolment will undertake a research project (possibly as a member of a research team
and/or in conjunction with a third party) as part of his/her candidature at the University (“the Research”).
B
During the term of his/her enrolment as a postgraduate degree research student, the Student may develop
commercialisable intellectual property of interest to the University (“Project Intellectual Property”).
C
The Student is the owner of the Intellectual Property Rights in the Project Intellectual Property.
D
The Student agrees to assign her/his Intellectual Property Rights in any Project Intellectual Property to the
University on the terms and conditions of this Agreement.
E
The University agrees to grant to the student the rights and benefits arising from the Project Intellectual Property
as set out in the University’s Intellectual Property Policy (which states inter alia that after the deduction of the
University’s costs, 50% of the net commercial benefits arising from the Project Intellectual Property will be
distributed to the creators of said Intellectual Property).
OPERATIVE PROVISIONS
I
n consideration of the rights and benefits conferred on the Student by the University's Intellectual Property Policy
(the receipt and adequacy of which the Student hereby acknowledges), the parties AGREE as follows:
1.
DEFINITIONS
“Background Intellectual Property” means any intellectual property which was developed by the Student
prior to enrolment as a candidate for a postgraduate research degree at the University and described in the
Annexure attached to this Agreement.
“Intellectual Property Policy” means the University’s policy on intellectual property which can be found at:
https://staff.mq.edu.au/work/strategy-planning-and-governance/university-policies-and-procedures/policies/
intellectual-property (a copy of which the Student acknowledges receipt of) as amended from time to time.
“Intellectual Property Rights” means all intellectual property rights anywhere in the world, including but not
limited to:
(a)
patents, copyright, EL rights (and similar rights outside Australia in circuit layouts), plant variety rights (and
s
imilar rights outside Australia in plant varieties), registered designs, trade marks, know-how, technical
information and any rights to have confidential information and knowledge kept confidential; whether
created before or after the date of this agreement; and
(b)
any application or rights to apply for registration of any rights referred to in paragraph (a).
“Materials” means the prototypes, working drawings, plans, modules, specifications, reports, copies, files,
software and all other materials relating to the Research and prepared by the Student or prepared by the Student
in conjunction with other University students, employees or third parties working with him or her.
Page 2 of 4
MQ ID:
A
ssignment of Student IP to the University
2.
ASSIGNMENT OF INTELLECTUAL PROPERTY RIGHTS AND LICENCE OF BACKGROUND
I
NTELLECTUAL PROPERTY
2.1.1
The Student hereby assigns to the University all his/her entire right, title and interest in any Intellectual
Property Rights in respect of the Project Intellectual Property in the Research and Materials.
2.1.2
The Student:
(a)
acknowledges that no additional documentation is necessary to complete the assignment made
under t
his clause and by virtue of this clause all existing and future Intellectual Property Rights in th
e
R
esearch and Materials (i.e. the Project Intellectual Property) vest in the University upon their
creation.
For the avoidance of doubt any Intellectual Property developed by the Student prior to enrolment as
a candidate for a postgraduate research degree at the University, or outside the scope of the
Research, will remain vested in the Student (see also Section 5).
(b)
must do all things reasonably requested by the University (at the latter’s expense) to enable the
U
niversity or its assignee or licensee to assure and/or exploit further the Intellectual Property Rights
assigned under this clause.
2.1.3
Where the Student is the owner of Background Intellectual Property and that Background Intellectual
Property is utilised in the Research, the Student will identify and disclose details of the Background
Intellectual Property in the Annexure attached to this Agreement.
2.1.4
Where the Background Intellectual Property is a necessary adjunct to commercialisation of the Project
Intellectual Property the Student, by separate agreement with the University (upon commercial terms to
be agreed by the parties) agrees to grant to the University an irrevocable, world-wide licence (including a
right of sub-licence) to use the Background Intellectual Property for commercialisation of the Project
Intellectual Property.
3.
EXPLOITATION AND ROYALTIES
3.1
Where, in its absolute discretion, the University wishes to exploit the Project Intellectual Property,
Research and/or Materials, it shall use all reasonable efforts in doing so. All royalties or other proceeds
of exploitation, whether by licensing or sale of the Project Intellectual Property associated with the
Research or otherwise, will be received by the University and shall be distributed in accordance with the
University’s Intellectual Property Policy. Any changes in the conditions governing the distribution of any
royalty income will only be made with the approval of both Parties to this Agreement.
3.2
As outlined in the University’s Intellectual Property Policy, where the University determines not to
commercially exploit the Project Intellectual Property the University shall within a reasonable period
reassign the Intellectual Property Rights in the Project Intellectual Property to the Student.
4.
PUBLICATION & REPORTING
4.1
Where the University is of the view that it is desirable to do so, it will take reasonable steps to protect the
P
roject Intellectual Property to ensure that patent or other protection may be obtained while the Student’s
thesis is in preparation and before any disclosure. Such steps shall not, however, involve delay in the
submission of the thesis nor the excision of material from the thesis that represents an essential or
significant part of the Student’s work, nor the prevention of the assessment of the thesis under the
University’s usual procedures. Copyright in the Student’s thesis shall be retained by the Student.
4.2
In accordance with University policy, Public access to the thesis may be restricted for a limited period (not
exceeding 12 months) to enable the Parties to arrange for protection of any commercial Intellectual
Property arising from the results of the Research.
4.3
The Student must immediately report any Intellectual Property Rights in the Research and Materials
created by the Student to his/her supervisor.
5.
DEVELOPMENTS
The Student acknowledges that any future developments of Intellectual Property Rights in the Project Intellectual
Property, Research or Materials made by the University, its employees, students, agents, affiliates or sub-
contractors will immediately vest in the University upon their creation.
Page 3 of 4
A
ssignment of Student IP to the University
MQ ID:
F
or the avoidance of doubt, the University makes no claim on any Intellectual Property Rights developed by the
Student following completion of his/her postgraduate research degree at the University (”Post Completion IP”)
except for in relation to Post Completion IP that incorporates or utilises Project Intellectual Property or any part
of Project Intellectual Property as pre-existing material.
6.
CONTINUING OBLIGATIONS
Each Party must do or cause to be done all things necessary or desirable to give effect to this Agreement, and
shall refrain from doing things that would hinder the performance of this Agreement or the exploitation of the
Project Intellectual Property, Research and/or Materials.
7.
FORMAL PROVISIONS
7.1
This Agreement together with any Annexures constitutes the entire agreement between the Parties
dealing with the Intellectual Property Rights in the Research and/or Materials and supersedes all prior
agreements and arrangements (if any) in relation to that Intellectual Property.
7.2
No waiver of any breach of this Agreement shall be deemed to be a waiver of any other or any subsequent
breach, nor shall the failure of either party to enforce at any time any of the provisions of this Agreement
be interpreted as a waiver of such provisions nor affect the validity of this agreement or any part of it, or
the right of the University to enforce each and every provision.
7.3
If any provision of this Agreement is held invalid, unenforceable or illegal for any reason, this Agreement
shall remain otherwise in full force apart from such provision which shall be deemed deleted.
7.4
Any amendment or variation to this Agreement is not effective unless it is in writing and signed by the
parties.
7.5
This Agreement shall take effect from the date upon which it is executed by the Student.
7.6
This Agreement is governed by and construed according to the laws in force in New South Wales and the
parties agree to submit to the jurisdiction of the courts of that jurisdiction.
EXECUTED as an Agreement in New South Wales in two parts on the dates indicated.
SIGNED by «FirstName» «LastName»
: …………………………………………………..
Signature of Student
…….
…………………………………………….
Date
i
n the presence of: …………………………….…………………….
Name of witness
…………
…………………………….………….
Signature of witness
O
FFICE USE ONLY:
(To be completed by the University’s authorised officer)
S
IGNED for and on behalf of
MACQUARIE UNIVERSITY
by an authorised officer:
…………
………………………………………..
Signature
…….
…………………………………………….
Date
i
n the presence of: …………………………….…………………….
Name & capacity of witness
…………
…………………………….………….
Signature of witness
Page 4 of 4
MQ ID:
A
ssignment of Student IP to the University
A
NNEXURE
L
IST OF BACKGROUND INTELLECTUAL PROPERTY
(
to be completed by the enrolling student, where appropriate)
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Completed 31 May 2021

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