B&T Application for Tuition Fee Refund (Compassionate Withdrawal)

Counselling, Chaplaincy & Spiritual Care

Application for Tuition Fee Refund (Compassionate Withdrawal)
Fill in this form to apply for a Tuition Fee Refund for compassionate reasons for subjects in Counselling, Chaplaincy & Spiritual Care courses.
Student Number *
Family Name *
First Name *
Email address *
Date of Birth *

Month Day Year
Date
Mobile *
Are you an overseas student? *

No Yes
Payment Method *

Fee-HELP Upfront Payment
Unit Details
Current Course *
Year *
Study Period *
Unit Code 1 and Lecturer's name *
Unit Code 2 and Lecturer's name (if applicable)
Unit Code 3 and Lecturer's name (if applicable)
Unit Code 4 and Lecturer's name (if applicable)
Unit Code 5 and Lecturer's name (if applicable)
Basis for Application
Reason for Application *

medical family/personal
Details of reason *
please provide a brief description of your current circumstances and how they are affecting your ability to complete your unit(s).
Documentation Provided *

Medical Certificate Letter of Support None
Uploads
Attach supporting documentation (2MB limit)
Attach additional 1 (2MB limit)
Attach additional 2 (2MB limit)
If this application is not approved, would you like the Registrar's Office to automatically process a Withdrawal from the unit/s (resulting in a Failed Withdraw - FW)? *

Yes No - if so, you will need to apply separately to withdraw
Should be Empty:

Counselling, Chaplaincy & Spiritual Care