Declaration of Co-curricular or Service Activity
This form is to be used by students who do not have access to an official document confirming participation in a co-curricular or service activity, though students are
generally expected to obtain official documentation. Additional information on co-curricular or service requirement and examples of accepted official documentation
can be found at http://www.anu.edu.au/study/apply/new-admissions-for-2020
The Australian National University
Admissions Office
Canberra ACT 2601 Australia
anu.edu.au/study/apply
E: domestic.admissions@anu.edu.au
T: +61 2 6125 5594
CRICOS Provider Number: 00120C
DD/MM/YYYY
4. Referee/Authorised person declaration
I declare that the information provided by the applicant on this form is complete and true. I declare that I conducted or
administered the activity described in this document. I also declare that I am not a relative of the applicant.
Full name:
Email:
Date
STAMP
(if applicable)
Signature:
Phone:
Position/Organisation:
3. Applicant declaration
I declare that I understand the requirements and have read the instructions (see reverse side) applicable to me. I declare that the
information provided in this form is true and correct and understand that the University may audit this.
Date
DD/MM/YYYY
Signature:
1. Applicant details
Full name:
ANU application
number:
School student
ID/number:
(if known)
Division of Student Administration
2. Activity overview
Activity name:
(e.g., Work, Volunteering)
Date you first
participated in the
activity:
DD/MM/YYYY
Period engaged in
activity:
(e.g., Jan 2018—Dec 2018)
Web link to activity:
(if applicable)
Total hours
engaged in activity:
Division of Student Administration
DOCUMENT SUBMISSION
This form and all additional documentation must be uploaded directly to your ANU application, using the application system no
later than the application deadline.
This form must be saved as a PDF smaller than 5MB with a file name no more than 40 characters
For assistance completing this document, contact:
ANU Admissions Office
E: domestic.admissions@anu.edu.au
T: +61 2 6125 5594
Instructions for Applicants
This document is to be completed only where you do not have access to acceptable supporting documentation confirming your
participation in a co-curricular or service activity. Supporting documentation is considered to be acceptable if it meets all of the
following criteria:
identifies you (the applicant, by full name) as having participated in the co-curricular or service activity; and
identifies the activity (by name) that you were involved in; and
identifies the dates that you were engaged in the activity, and where applicable, confirms you have meet the
relevant commitment requirements, as defined in the co-curricular or service schedule.
Time requirements and examples of acceptable supporting documentation can be found here:
http://www.anu.edu.au/study/
apply/new-admissions-for-2020
Instructions for Referee/Authorised person
An individual or an organisation is considered to be a Referee/Authorised person when the following criteria are satisfied:
the named Referee/Authorised person conducted or administered the activity described by the applicant or is a
competent school authority who can attest to the activity claimed by the applicant; and
the named Referee/Authorised person is not a relative of the applicant.
If applicants are unable to identify a Referee/Authorised person that can attest to their involvement in a co-curricular or service
activity, they are encouraged to get in touch with the domestic admissions team (contact details are given below).
Auditing of documents
All applicants must meet all ANU admission requirements, including the co-curricular or service requirement. Documents
supporting an application for admission must comply with current standards and may be subject to a back to source audit.
ANU does not require certified copies of documents to be provided during the application process. Instead, applications for
admission are audited by contacting the issuing body and requesting confirmation of the documents presented. Information on
the audit processes we may undertake are outlined in the declaration on the application system.
Applicants are able to download a copy of all application declarations from the application system.
The Australian National University
Admissions Office
Canberra ACT 2601 Australia
anu.edu.au/study/apply
E: domestic.admissions@anu.edu.au
T: +61 2 6125 5594
CRICOS Provider Number: 00120C
Declaration of Co-curricular or Service Activity
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