For more information about Stupac services, print out this form,
fill it in and fax on +61-2-9319 4828




Yes, I would like to obtain further information about Stupac services.

Family Name
 
Other Names (include all given names)
 
Male Female Date of Birth //
Australian University
Campus Date of arrival in Australia //

Home Address
Street
Suburb City
Country Postcode
Home Phone ()

Address for correspondence in Australia (if known)
Street
Suburb    
City Postcode
Telephone (in Australia) ()


SIGNATURE___________________________________DATE______________

MAIL COMPLETED FORM TO:
Stupac Services Division, Australian Universities Credit Unions & Co-operatives,
PO BOX 1745, Strawberry Hills NSW 2012 AUSTRALIA


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