CAVAL registration / enrolment form (Victoria only)

Please fax the completed form to (03) 5122 6535 or +61 3 9902 6535, or, post to
Library Services for Off-campus Students
Monash University Library
Churchill, VIC 3842 Australia

Family name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Given name: _ _ _ _ _ _ _ _ _ _ _ Monash ID no: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Course: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Postal address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Status:

[ ] Student	[ ] Undergraduate	[ ] 4th year Honours
[ ] Grad. Dip.	[ ] Masters & above	[ ] TAFE
[ ] Other_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

I wish to register as a CAVAL Reciprocal borrower. I have read the rules and regulations and I accept that in event of failure to abide by them I will be responsible for payment of any fines or other charges incurred. I will notify all relevant libraries of any changes of address.

Signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date: _ _ _ _ _ _ _ _ _ _ _ _

Privacy statement

The information on this form is collected for the primary purpose of processing CAVAL Reciprocal Borrowing Program registrations. Other purposes of collection may include administrative matters and statistical analyses. If you choose not to complete all the questions on this form, it may not be possible for the Library to accept and process the registration request. You have a right to access personal information that Monash University holds about you, subject to any exceptions in relevant legislation. If you wish to seek access to your personal information or inquire about the handling of your personal information, please contact the University Privacy Officer on 9905 6011.

Office use only:
[ ] Student database checked; [ ] library catalogue checked

Checked by: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date: _ _ _ _ _ _ _ _ _ _ _ _

Received: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Sent: _ _ _ _ _ _ _ _ _ _ _ _