Application form
Bachelor of Human Sciences
(Alternative exit)
ST U D ENT D ET AI L S
Student ID
First Name
Surname
C U R R ENT CO U R SE D ET AI L S
Please select the course you are currently undertaking
Course Title
Course code
Bachelor of Medicine and Bachelor of Surgery (undergraduate program)
Bachelor of Medicine and Bachelor of Surgery (Honours)
0040, 3856,
4531, 4533
Bachelor of Medicine and Bachelor of Surgery (graduate program)
Bachelor of Medicine and Bachelor of Surgery (Honours)
3952, 4532
Bachelor of Occupational Therapy
Bachelor of Occupational Therapy (Honours)
Bachelor of Physiotherapy
Bachelor of Physiotherapy (Honours)
Bachelor of Physiotherapy (with Honours)
Bachelor of Physiotherapy Advanced - Research (Honours)
Tick one only
3869, M3001
3868, M3002
3891, M3003
APPLY TO GRADUATE
Once you have completed and submitted this form, please ensure you apply to graduate:
http://www.monash.edu.au/graduations
ST U D ENT SI GN AT U R E
By signing this form I agree and accept the Bachelor of Human Sciences as an alternative exit from my original degree indicated above.
I understand that once this alternative exit has been awarded, I may not recommence the original course of study.
Student Signature:
Date:
___ / ___ / _____
C U R R ENT CO U R SE D ET AI L S – t o be c om pl et ed b y t h e cou r se c oo r di na to r o r ad min is t ra to r
The student must pass the following course requirements to be eligible for this course
Has the student passed 144 credit points?
YES
Has the student met the requirements relevant to the current course?
 Core units for years 1 , 2 and 3, or in the case of the four-year graduate MBBS, years A,B and C
 Refer to course handbook entry for the year of commencement http://monash.edu.au/pubs/handbooks/
YES
Course Coordinator’s Signature:
Date:
___ / ___ / _____
C AL L I ST A PR O C ES SI N G – to b e c om pl ete d b y a d mi ni st r at o r
Unit Set (specialisation) added
YES
Alt exit processed
YES
Original course discontinued with reason “alternative exit taken”
YES
RECORDS
Course administrator to store completed form on TRIM
Privacy Statement: The information on this form is collected for the primary purpose of assessing your course application, attending to administrative
matters and statistical analyses. If you choose not to complete all the questions on this form, it may not be possible for Monash University to assess
your application. 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 privacyofficer@adm.monash.edu.au