Application for Replacement JCU Award (Certificate/Testamur) - FM-EX-VMar2018
REQUEST FOR REPLACEMENT JCU AWARD
(CERTIFICATE/TESTAMUR)
1. PERSONAL DETAILS
JCU Student Number (8 digits): Title: rDr rMr rMs rMr s rMiss rOther:
First given name: Family name:
Mailing address:
Suburb: State: Postcode:
JCU email address: Daytime phone number:
Signature:_________________________________________________________________ Date: _______/________/_________
INSTRUCTIONS AND CONDITIONS
• Statutory Declaration (outlining the reasons for the loss or destruction of the original) MUST accompany this form unless a damaged
testamur is returned. The declaration is to be certified by a Justice of the Peace. Your application will not be processed without this
form.
• Applications take a minimum of 2 - 4 weeks to process and will only be issued after the fee is paid.
• Fees:
$80 – Replacement testamur to be posted to an Australian address or collected in person from the Student Centre.
$120 – Replacement testamur to be posted to an international address.
Replacement testamur includes Diploma, Bachelor, Master and Doctoral qualifications
• Replacement certificates: $20.00 (eg Certificate of Business)
• Payments - Student Centre by EFTPOS or Credit card (see below) only.
• For collection by another person, a statement signed by the applicant authorising collection must be provided.
• Applicants and authorised third parties must provide photo identification at the time of collection.
2. INFORMATION REQUIRED
Please indicate the award or awards to be replaced (eg Bachelor of Arts, Graduate Diploma of Science,
Postgraduate Diploma of Arts, Doctor of Philosophy etc):
Award 1 ___________________________________________________ Year:_________________________________________________
Class of Honours (if relevant):
r l r llA r llB r lll Major:_________________________________________________
Award 2 ___________________________________________________ Year:_________________________________________________
Class of Honours (if relevant):
r l r llA r llB r lll Major:_________________________________________________
3. COLLECTION / POSTAGE DETAILS
Please select: Collect from: r Townsville, Student Centre , Education Central (Bld. 134)
r Cairns, Student Centre (Bld. A1)
Or by: r Ordinary mail r Express Post r Express Post International
4. CREDIT CARD DETAILS
Name on credit card: ____ ___________________________________ r MasterCard r Visa
Credit card number: CVV: Expiry date: ______/______
Amount: ___________ Cardholder’s signature: ____________________________________ Date: _______/________/_____________
Student’s signature if dierent from above: ______________________________________ Date: _______/________/_____________
5. FORM RETURN AND ENQUIRIES
Townsville
James Cook University, Student Centre
Education Central (Bld. 134) Townsville, 4811
Telephone: (07) 4781 5255
exams@jcu.edu.au
Cairns
James Cook University, Student Centre
Chancellery Building (Bld. A1), Cairns, 4870
Telephone: (07) 4232 1000
Email: exams@jcu.edu.au
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