Change of Personal Details Form

Change of
Personal Details
Personal Information
Please note, a change of name will require original documentation. These
original documents must be presented to, copied and certified by either a
Human Resources representative, your supervisor or a Justice of the Peace.
ID number
New Name
Courtesy Title
First Name
Second Name
Third Name
Family Name
First Name
Second Name
Third Name
Family Name
Previous Name
Courtesy Title
Preferred Name
Gender
Male
Home Phone Number
Female
Mobile Phone Number
Indeterminate/Intersex/Unspecified
Email Address
Home Address
Postal Address
Personal and emergency contact details can be updated via the Web Kiosk (http://www.csu.edu.au/division/hr/web-kiosk).
Signature
Last Reviewed: August 2013
Date
Asset ID # 570614