This form must be completed by the applicant and not an agent or representative, as it contains personal background information which will only be known by the applicant.
You should set aside a minimum of 30 minutes to complete this form. Please note it is not possible to partially complete sections of this form and return to it later.
Please note that any information supplied by you to AUT will be subject to the Oﬃcial Information Act 1982 and the Privacy Act 1993. AUT may seek clariﬁcation from you, or request further information in relation to any information you provide in this form.
Please include other alias or alternate names; married name if not your primary name; previous/maiden/name changed by deed poll or statutory declaration.
Add another previous name
Permanent residential address
Programme(s) you have applied for