I consent to CSU Global disclosing my personal information to my designated Emergency Contact and any Australian or
foreign government agencies, for any purpose related to the protection of my safety and welfare.
I acknowledge that CSU does not warrant that the host country is a safe and suitable country for overseas travel and that my
decision to travel to a particular country or region is a personal one.
I acknowledge that I am required to register my travel online at
http://www.smartraveller.gov.au/ and Travel Tracker to keep
myself updated with the latest travel advice from this website.
I acknowledge that I am required to undertake the CSU Global Pre-Departure modules and agree to follow any relevant
directive issued by the Australian Embassy or High Commission or other Australian Government representative in the host country.
I understand that CSU can require my withdrawal from the program should it deem political instability and/or terrorist activities
in the region to be unsafe for me to remain in my host country.
My participation in the Program
I agree to advise CSU Global of any changes in the arrangements of my program.
I understand and accept that I must comply with the laws applicable in the host country at all times and that any failure to do so
may result in my expulsion from the host country at my own cost.
I understand that I am bound by, and must comply with, the
CSU Academic and Student General Misconduct Rule at all times
during my program.
I will not participate in any activity, including political activity, which might endanger the reputation of CSU, or undermine the
effectiveness or viability of the program.
I am responsible for applying for and obtaining any relevant visa associated with my travel.
I understand that it is my responsibility to negotiate and obtain approval from CSU for obtaining academic credit for study
My financial obligations
I understand that my participation in this program and associated travel is my sole responsibility and I assume all financial
responsibility, including debt, arising from such circumstance.
I am aware of the likely living cost of my stay overseas, and I have the necessary financial capacity to meet such costs for the
full duration of my exchange period.
I agree that I am responsible to ensure that my travel and medical insurance covers me for the total period of my travel
including any independent travel before, after and during the program.
I agree to indemnify CSU for any expenses, losses, damages and costs that I may sustain or incur as a result, whether directly
or indirectly, of any action arising from any failure by myself to obtain or maintain travel and medical insurance coverage.
I understand that CSU will not be liable in any way for injury, sickness or damage that I may suffer during my participation in
the program and/or resulting from the travel arrangements and any other related or incidental activities during this program.
I have sought and obtained appropriate advice on my responsibilities as set out in this Acknowledgement, Declaration and
I understand that this Acknowledgement, Declaration and Agreement cannot be modified or amended except in writing by
I consent to the distribution of my personal and contact details to CSU divisions, external organizations and Government
departments in relation to this program. Please note if you are a participant in a government funded program part of the funding
agreement is that your personal details will be released to this body.
DO NOT TYPE NAME dd/mm/yy
You may be eligible for a Vice Chancellors Travel Grant in association with your international program. On
receipt of this registration form CSU Global will assess your eligibility and contact you in relation to additional
information you may need to provide in order to receive this grant.
CSU Global Independent Program Registration Page 4 of 4