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Annual course registration form

* Required
Section 1 Application details
 
(Please provide postal address if different to above)
 
   
Contact details
Head of department/CEO contact details
   
Course leader contact details
   
Fieldwork placement 1 coordinator
   
Fieldwork placement 2 coordinator
   
Estimated number of students
On campus/face to face  
 
Off campus / distance education
 
Mode of delivery Delivery hours
Curriculum Name
(course and /or education provider)
Campus location Fieldwork placement
(hours / delivery / sequence)
Fieldwork placement agencies Staffing changes
(Course leader / Fieldwork placement / Staff turnover)(Please provide new staff matrix including position / unit allocations, qualifications and industry experience including organisations, dates and roles.)
Other changes  (Please specify)
No changes (go to section 3)