Students who have already enrolled at UB are unable to use the online 2010 Application to Defer form. Please call 1800 811 711 for further information.
Program Name:
Student Number:
School:
Family Name/Surname:
Given Name:
Date of Birth:
Male
Female
Address:
City/Suburb/Town:
State:
Postcode:
Telephone:
BH
AH
Mobile:
Email Address:
Please supply a valid email addresss. Any application received without a valid email address
will not be accepted.
