Print name Date: .............................................. title Execution SIGNED for and on behalf of SIGNED by THE UNIVERSITY OF QUEENSLAND the Student in the presence of: by its duly authorised officer: in the presence of: .............................................. .............................................. Signature Witness .............................................. .............................................. Executive Dean / Director Witness (Print Name) .............................................. .............................................. Date Name of Witness .............................................. ..............................................
Execution SIGNED for and on behalf of THE UNIVERSITY OF QUEENSLAND by its duly authorised officer: in the presence of: .............................................. Executive Dean / Director .............................................. Print name .............................................. title .............................................. Witness (Print Name) .............................................. Date: SIGNED by the Student in the presence of: .............................................. Signature .............................................. Date .............................................. Witness .............................................. Name of Witness
20171006_Student_intellectual_property_confidentialitydeed.docx