Student Access Request Form

Student Name:

Student Number:

Subject or course you are enrolled in:

Student Email Address (Unimelb Account Only):

Areas you are experiencing access problems:

• HBA Museum
• Dissection Hall

Student Card Expiry Date:

Day -- Please Select --12345678910111213141516171819202122232425262728293031

Month -- Please Select --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Year -- Please Select --201620172018201920202021202220232024202520262027

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Please enter your email address:
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