Education Agent Nomination and Authorisation

You must complete this form if you have appointed a University of Melbourne education agent to assist you with your application to the University of Melbourne.

The form MUST BE COMPLETED BY THE APPLICANT and not the education agent.

By completing this form you are:

Authorising the education agent nominated in SECTION B to act on your behalf for this eApplication; and
Agreeing to information relevant to your application, visa and admission being released to the education agent. Your education agent will be included in all correspondence regarding the progress of your application.

Before completing this form, review and note the information and any restrictions outlined at:
https://study.unimelb.edu.au/how-to-apply/find-an-overseas-representative

If you have already authorised an education agent to manage your application and are changing to another education agent, you will be required to provide further information including the reasons for changing agents in SECTION C.

- 请用英文输入信息

如果您的年龄低于 18 岁，则此表格必须由您的父母填写。

Form #84

UoM Student ID Number (if known):

SECTION A: STUDENT DETAILS

Title

Given Names

Middle Name (if Applicable)

Family Name

Country of Passport

Telephone

Date of Birth

Gender

Country of Birth

Marital Status

SECTION B: AGENT DETAILS

The University of Melbourne Education Agent you are authorising to act on your behalf.

AGENT DETAILSAgent Company Name:

Agent Office (City):

Agent Office (Country):

Counsellor’s Name and Email:

Please tick one of the following options that best describes your circumstance:

I am living, working and/or studying in the country where the education agent is located.

Other (please explain):

Note: You can only use a University of Melbourne education agent listed in your country.

See the education agents listed for your country at:
https://study.unimelb.edu.au/how-to-apply/find-an-overseas-representative

SECTION C: CHANGE OF AGENT

If you have already authorised an education agent to manage your application and are changing to another
education agent:

You must complete this section, and
Provide details of the University of Melbourne Education Agent you previously authorised.

Provide details of the University of Melbourne Education Agent you previously authorised.Previous Agent Company Name:

Previous Agent Office (City):

Previous Agent Office (Country):

Date you first authorised this agent:

Why are you changing agents? Do any of the following apply?

I have moved and the new agent is in a more convenient location. Please provide your new address:

I am not satisfied with the service provided by my previous agent. Please specify:

Other (please explain):

Confirmation that you are withdrawing your authorisation for the previous agent to act on your behalf.

I confirm withdrawal of my authorisation for the agent shown in SECTION C to act on my behalf.

Please note:

Please note:

This change of agent is subject to approval.
If approved, the agent shown in SECTION C will be notified in writing that you have withdrawn your authorisation. They will not be included in any further correspondence about the progress of your application.
Once the change of agent is approved, your login and password for eApplication will be reset, and a new password will be sent to your personal email address provided in SECTION A.

SECTION D: CHANGE OF AGENT

I have completed the Education Agent Nomination and Authorisation Form myself.
I authorise the education agent shown in SECTION B to represent me in all dealings with the University of Melbourne regarding my application.
I acknowledge that the University of Melbourne reserves the right to reject this request for the education agent to act on my behalf.

HOW TO SUBMIT THIS FORM

Upload this form to your course application in the eApplication system under the Requirement – Appointment of authorised representative.
If you have trouble uploading the document, you can email this form to your nominated agent.

免责声明：
我们不是官方教育提供者。作为独立的教育代理，我们协助查询并提供有关教育机会的指导。我们网络中的一些代理可能与特定的教育机构有正式的合作伙伴关系并直接代表他们。然而，任何最终决定、要约或协议均由相应的教育机构单独做出。共享的所有信息仅供参考。

索取更多信息

The University of Melbourne (UniMelb)

CRICOS CODE 00116K

机构名称:

The University of Melbourne (UniMelb)

还交易为:

墨尔本大学

机构 Cricos 代码:

00116K

机构类型:

Government

地点:

Victoria 3010

网站:

https://www.unimelb.edu.au/

学生总数:

40500

- 请用英文输入信息

如果您的年龄低于 18 岁，则此表格必须由您的父母填写。

HOW TO SUBMIT THIS FORM

与您的网络共享此页面

索取更多信息

The University of Melbourne (UniMelb)

CRICOS CODE 00116K

Education Agent Nomination and Authorisation

机构名称: The University of Melbourne (UniMelb)

还交易为: 墨尔本大学

机构 Cricos 代码: 00116K

机构类型: Government

地点: Victoria 3010

网站: https://www.unimelb.edu.au/

学生总数: 40500

- 请用英文输入信息

如果您的年龄低于 18 岁，则此表格必须由您的父母填写。

HOW TO SUBMIT THIS FORM

与您的网络共享此页面

机构名称:

The University of Melbourne (UniMelb)

还交易为:

墨尔本大学

机构 Cricos 代码:

00116K

机构类型:

Government

地点:

Victoria 3010

网站:

https://www.unimelb.edu.au/

学生总数:

40500