Register

Title:

First Name(s):

Please enter the first name(s) / given name(s) on your passport
*

Other Names:

Last Name:

Please enter the last name (family name) on your passport
*

Previous Last Name:

Nickname (English Name):

Please enter your nickname or English name
*

Gender:

Date of Birth:

//* (age: 0 years 0 months)

Birth Country:

Citizenship Country:

Is International Student?*
This information is only being collected for statistical purposes.

Applicant Phone:

Applicant Mobile Phone:

Applicant Work Phone:

Applicant Fax:

Email:

Please enter student's email address
(not that of a La Trobe University representative)
Your new username and password will be sent to this address
*

Were you previously enrolled at La Trobe University?*

Previous LTU Student Number:

Passport Number:

Applicant is a permanent resident of Australia*

Please type the code displayed:

International