Approved by the Vice-Chancellor: 26 April 2017

MTS to MTH EXCHANGE form

Approved by the Vice-Chancellor: 26 April 2017

This form is for alumni of the University of Divinity or Melbourne College of Divinity who graduated with the Master of Theological Studies, or MTS, prior to 30 April 2017. From 1 September 2017 the name of the award will be Master of Theology (Coursework), or MTh. For a limited time, existing graduates with the MTS may exchange their testamur and academic transcript for new academic documents bearing the new name of the award.

Applications must be lodged by 30 September 2017 with your College, or directly to:

John Bartholomeusz, Office of the Vice-Chancellor, 21 Highbury Grove, Kew VIC 3101

New academic documents will be issued to all approved applicants in December 2017.

1. APPLICANT DETAILS
Full Name
College
Postal Address (for delivery of documents)
Email
Year of MTS Graduation
2. APPLICANT’S DECLARATION
I graduated with the Master of Theological Studies prior to 30 April 2017 and wish to exchange my academic documents and be supplied with new academic documents for the Master of Theology (Coursework) [MTh].
Signature / Date

YOU MUST ATTACH:

EITHER provide the original of your MTS testamur (degree certificate) OR complete the statutory declaration and have it witnessed. Documents may be lodged with your College who will forward this application to the Office of the Vice-Chancellor.

Office of the Vice-Chancellor use only
Date application received
Date documents supplied

STATUTORY DECLARATION

Please complete the form below ONLY if you are unable to provide the original testamur (degree certificate) for your MTS.

I, ______(full name)

of, ______(address)

______(occupation)

do solemnly and sincerely declare that I graduated with the degree of Master of Theological Studies from the University of Divinity or the Melbourne College of Divinity prior to 30 April 2017 and that the testamur (degree certificate) I received for the Master of Theological Studies has been lost or destroyed and I am unable to provide the same to the University of Divinity.

I acknowledge that this declaration is true and correct, and I make it with the understanding and belief that a person who makes a false declaration is liable to the penalties of perjury.

Declared at ______

this ______day of ______2017.

______

[Signature of person making this declaration, to be signed in front of an authorised witness.]

Before me,

______

[Signature of authorised witness.]

The authorised witness must print or stamp his or her name, address and title under section 107A of the Evidence (Miscellaneous Provisions) Act 1958 (as of 1 January 2010), (previously Evidence Act 1958), (eg. Justice of the Peace, Pharmacist, Police Officer, Court Registrar, Bank Manager, Medical Practitioner, Dentist).