Advocacy Assistance Application Step 1 of 3 - Provide us with your details 0% Name* First Last Date of Birth* DD MM YYYY Student Number*Phone*Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Have you booked an appointment or are currently in contact with our Advocacy Office?*YesNoWho is your assigned Advocacy Officer?Isabelle ChassainMarita TomlinsonKim SpencerUnsure Campus*ToowoombaSpringfieldIpswichDistance EducationInternational Student*YesNoVisa Expiration Date:*Sponsored Student*YesNoStudy Level*PostgraduateUndergraduateResearchNon-AwardFaculty/School of Study*BELAHESOACProgram*Courses Involved*Lecturer/USQ Staff Member InvolvedSemester*S1 2017S2 2017S3 2017S1 2018S2 2018S3 2018S1 2019S2 2019S3 2019Assistance Regarding:*Appeals (Final Grades/Exclusion/Academic Integrity)Academic Integrity (Including Misconduct)Enrolment/ Assessment/ Conceded Pass/ University RegulationWWP/ Special Consideration or SimilarGrievance with University/ Faculty/ DepartmentHarrasmentOtherDetails*Please provide as much detail as you can in a chronological order.Unofficial Academic Transcript*Students may view and print out unofficial academic transcript via Student Centre online. UConnect > Student Centre > Online Requests tile > Add New Request > Unofficial Transcript menu item > click the Unofficial Transcript PDF. This will open in a new window or tab. Please check your pop up blocker settings if the document does not automatically open when you select it.Photo ID (Student Card, Drivers License, Passport etc.)?Additional Supporting Documents? How did you hear about us?*Recommended by FacultyRecommended by USQ StaffRecommended by Other StudentRecommended by FriendFacebookSkypeEmailPhoneFace to FaceRepresentation Required*YesNoPrivacy/Authority Statement* Yes, I Agree No, I do not Agree I authorise and give my permission to the USQ Student Guild Advocacy Office to act on my behalf, as my representative. I authorise the USQ Student Guild Advocacy Office to make enquiries on my behalf in relation to all matters with respect to my student affairs and records as held in my name or as identified by my Student Number. I hereby appoint the USQ Student Guild Advocacy Office as my Student Advocate (as defined in the University of Southern Queensland’s Policy and Procedure Library [TRIM Record No 15/1862PL]) in accordance with the University of Southern Queensland Policies and Procedures, namely Academic Appeal Procedure, Non-Academic Appeals Procedure, Student General Misconduct Procedure and the University Appeal Procedure. I further hereby authorise and permit the USQ Student Guild Advocacy Office to send and receive, access, share (with the relevant involved parties) and hold my personal and private information as a Student of the University of Southern Queensland. This Authorisation shall be considered valid until such time that the matters I have sought assistance from the USQ Student Guild Advocacy Office from have concluded or until such time that I revoke my authority in writing. I agree and confirm that any and all acts carried out by the USQ Student Guild Advocacy Office on my behalf, in relation to this matter, shall be considered as having the same effect as if I was to have undertaken the particular act or actions myself. I confirm that I have read and understood this Privacy/Authority statement.Prove that you are not a Robot!CommentsThis field is for validation purposes and should be left unchanged.