Request for access to personal learner record and information This form may be completed by a learner, by an individual with confirmed authority from the learner to do so or by the parent/guardian of an underage learner. All individuals who complete this form will be required to supply evidence of their identity. AIE will try to provide you with your record/information within 30 days of receiving your request There is no charge for requesting access to your record/information. However in some cases there may be a charge to cover the time we spend locating, compiling and forwarding your request. AIE will advise you of this charge up front and confirm you wish to proceed. Section 1 - Learner DetailsName* First Last The course you are currently enrolled in*CUA20215 Certificate II in Creative IndustriesCUA31015 Certficate III in Screen and MediaICT20115 Certificate II in Information, Digital Media and TechnologyICT30118 Certificate III in Information, Digital Media and TechnologyCUA30715 Certificate III in Design FundamentalsCUA51015 Diploma of Screen and Media - Game DesignCUA51015 Diploma of Screen and Media - 3D Animation for Games and Film VFXICT50215 Diploma of Digital and Interactive Games - Game Programming10702NAT Advanced Diploma of Professional Game Development - Game Design10702NAT Advanced Diploma of Professional Game Development - Game Art10702NAT Advanced Diploma of Professional Game Development - Game ProgrammingCUA60615 Advanced Diploma of Screen and Media - 3D Animation and VFX for FilmBSB80615 Graduate Diploma of Management (Learning) specialising in Games BusinessAIE Student ID Number*USI NumberDate of Birth* Date Format: MM slash DD slash YYYY Campus*SydneyMelbourneCanberraAdelaideOnlineEmail Best contact number*Please advise what records, documents or information you would like to access*Learner recordAcademic recordPersonal information AIE is holdingPlease advise what what you would like to do*View your record/information in personRequest copies of your record/information by post (to address on record)Request copies of your record/information by email (to email address on record) Are completing this form on behalf of the learner?*Yes, I am requesting information on the Learner on their behalfNo, I am the LearnerPlease upload a photo or scan of a photo identification document you have to attach to this form.*Accepted file types: jpg, gif, png, pdf.This could be a driver's license or passport.Section 2 – Request for release of information on behalf of the learnerPlease confirm your delegated authority to do so*I have attached evidence of consent/delegated authorityThe Learner must complete Section 4 - Declaration belowUpload evidence of consent/delegated authority Drop files here or Accepted file types: jpg, gif, png, pdf. Person requesting information (if not the Learner) First Last Relationship to LearnerEmail of Requester Phone of RequestorSection 3 – Request for release of information on behalf of an underage learnerIf you are completing this form on behalf of an underage learner you are required to confirm your authority as a parent or guardian to do so I certify that I have parental responsibility for this child and that there are no circumstances, causes or Court orders which affect my parental responsibility for this child.Section 4 – DeclarationConfirmation I declare that all the information I have provided is true and correct.Name of person completing this form First Last To prove your ID as the Learner, please upload a photo or scan of a photo identification document to attach to this form.*Accepted file types: jpg, gif, png, pdf.This could be a driver's license or passport.CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.