RESEARCH OFFICE
Author Declaration, Research Publications
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Please complete this form if your CSU affiliation was NOT identified on the research publication itself, but the research leading
to publication WAS completed in your capacity as an affiliate of CSU.
1. Author Details
Title
First Name
Staff
Last Name
Student
ID number:
School or Centre
Faculty <select>
Phone
Email
2. Publication Details
Title of Article/Paper/
Chapter/Book
Title of Parent Journal/
Book/Conference
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Affiliation
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Publication
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Research Office: Author Declaration, HERDC (Research Publications) 080316
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Title of Article/Paper/
Chapter/Book
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Book/Conference
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Research Office: Author Declaration, HERDC (Research Publications) 080316
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Title of Article/Paper/
Chapter/Book
Title of Parent Journal/
Book/Conference
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School/Centre
Affiliation
Year of
Publication
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3. Approvals and Authorisations
PLEASE NOTE: This is an electronic form and requires the below authorisations in the order they appear. After each
authorisation this form needs to be emailed to the next signatory by clicking the `submit by email to next signatory' button and
entering in the next recipient's email address. For any queries about this form please contact the Research Office.
Student / Staff
I certify that I undertook the research leading to the publication listed above in my capacity as a staff/student member of CSU.
Name
Signature
Date:
Submit by Email to the
Research Office
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Research Office: Author Declaration, HERDC (Research Publications) 080316
P3/3