Application to Graduate 2011 The 2011 graduation ceremony will take place on Thursday 12 May 2011. If you intend to graduate in 2011, you must complete this form and submit by email, post or fax before 4 April 2011 to: Graduations Officer, 21 Highbury Grove, KEW VIC 3101 Australia, email firstname.lastname@example.org; fax 03 9853 6695. You will then be sent a letter of confirmation with further instructions about your graduation. A. STUDENT DETAILS Please enter your contact details below. If your name has changed since you last re-enrolled, please verify by forwarding a copy of the photo page of your passport, your birth certificate or evidence of name change via deed poll. Given Names: Family Name: Postal Address – Street Number & Name: Suburb: State: Postcode: Country: Telephone (Day): Telephone (Evening): Mobile: Email Address: Are these your permanent contact details? Yes No Please select one option. B. AWARD Please enter the name of the award(s) in which you are applying to graduate below: C. CONFERRAL DETAILS (Please select one option) I will participate in the Conferral Ceremony at Wilson Hall, University of Melbourne, Thursday 12 May 2011 at 7.30pm. (If you select this option, you must complete Section D.) OR I wish to graduate in absentia and receive my testamur by post at the postal address listed in Part A. (If you select this option, go straight to Section E.) Continue over page D. PAYMENT DETAILS (There is no need to complete this section if you are not attending the ceremony) There is no fee for graduating in absentia. If you are attending the ceremony, the graduation fee is $150, whether you are receiving one award, or more. If you intend to participate in the ceremony, please select one option below and complete relevant payment details. Please note that this fee is non-refundable after 4 April 2011. I attach a cheque or money order for $150 made out to “Melbourne College of Divinity”. (If you are paying by cheque, please print out the completed form, attach the cheque and send to postal address listed at top.) OR I give authority for Melbourne College of Divinity to debit my MasterCard or Visa with details as follows: Card Number: Expiry date:Month: Year: Name as shown on card: Amount to be debited: $150 Signature of cardholder (not necessary if submitting electronically)________________________________________ (For security reasons, your credit card will not be debited online. If you prefer, you may print this form and submit by post, or, you may leave the credit card details blank, then call the MCD on 9853 3177 during office hours with your credit card details to arrange payment.) E. CONDITIONS OF GRADUATION 1. To my knowledge, I have completed accurately all details requested. 2. I have no fees outstanding to the MCD or any MCD teaching institution. 3. I understand that I am not eligible to graduate until I receive an official letter from the MCD informing me of the details of my graduation. 4. I understand that the MCD may use any photographs taken at the Ceremony for promotional purposes. 5. Should any of my contact details change between submission of this form and the Conferral Ceremony, I undertake to notify the MCD of my new details immediately. 6. If I am attending the ceremony: (a) I understand that I must wear the correct academic regalia for the award I am receiving, as listed at: http://www.mcd.edu.au/graduation. I must also show to MCD staff that I have the correct academic regalia when I register at the graduation registration desk. (b) I have noted the times for registration and seating listed at: http://www.mcd.edu.au/graduation. I understand that if I arrive after the registration desk closes, or am seated after the roll call, I cannot process to the stage to receive my award, but will graduate in absentia and receive my award through the post. I ACCEPT THE ABOVE CONDITIONS OF GRADUATION. (You must check this box if you wish to graduate) Today’s date: F. ALUMNI MEMBERSHIP I give consent for my name to be included on the MCD Alumni/ae List: YES NO The information you have provided will remain confidential, and be used only for the purposes acknowledged on this form. It will be kept securely. Information Sheet - Conferring of Degrees and Awarding of Diplomas The Conferral Ceremony for 2011 will take place on Thursday 12 May at 7.30pm in the Wilson Hall, University of Melbourne, Parkville. Supper will be provided, at no cost, at the conclusion of the Ceremony. Graduands are strongly encouraged to be present and may invite three guests to the Graduation Ceremony and supper. No tickets are required. A photographer will be present to take Graduation photographs. Certificates for graduands who receive their awards in absentia will be forwarded shortly after the date of the Conferral Ceremony. In order to graduate, irrespective of whether you will graduate in person or in absentia you must complete the attached form and return it by 4 April 2011. MCD Regulations stipulate that until all fees have been paid and the award conferred, you are not entitled to use the relevant academic letters after your name. Academic Dress The Conferral Ceremony is a formal academic occasion requiring correct academic dress. Anyone not wearing correct academic dress will not be permitted to participate in the Ceremony. The MCD does not have gowns and hoods for hire, however, the Grad Shop at the University of Melbourne both hires and sells academic dress. All bookings can be made online at http://www.thegradshop.com.au. If you do not have internet access, please call (03) 8344 4822. The Grad Shop will ensure you are correctly robed if you inform staff of your award. Hired academic dress is collected from and returned to The Grad Shop at Union House, University of Melbourne on the day of the Ceremony. Academic dress can also be purchased from: R W Bredin & Son, 136 Station Street, Aspendale Vic 3195. Phone: (03) 9587 8100; Website: www.bredin.com.au (suppliers to the University of Melbourne Regalia Shop). Blashki, Unit 2/36-40 New Street, Ringwood 3134. Phone: (03) 9870 7100. Website: www.blashki.com.au Send completed form and graduation fee of $150, if applicable, by MONDAY 4 APRIL 2011 to: Graduations Officer Melbourne College of Divinity 21 Highbury Grove KEW VIC 3101 Australia Please note that applications received after 4 April 2011 will not be processed.