CHANGE OF COURSE/COURSE LOCATION REQUEST FORM

CHANGE OF COURSE/COURSE LOCATION REQUEST FORM
Please note: Changing your course/course location may affect your academic progress. You may fall behind your schedule and might not be able to complete your course within the period allocated for it. Business Institute of Australia will NOT be responsible for any shortcomings in your academic progress caused by your decision to change your course/course location. Please note that the change of course/course location fee is $200 per application.
STUDENT DETAILS:
Name *

First Name Last Name
Student ID *
Phone Number *

Area Code Phone Number
Address *

Unit No.

Street Address

Suburb State / Province

Postal / Zip Code
Email Address *
example@example.com
Course Name:
COURSE INFORMATION:

Current course details
Course Offered/Enrolled in:
Start Date:

Day Month Year
Date
Campus:
Requested course details
Requested Course
Proposed Start Date:

Day Month Year
Date
Campus:
Reason(s) *
Reason(s)

Cancel of
STUDENT DECLARATION:

I declare that all the information I have given above is correct and complete. I confirm that I have read all the terms and conditions and agree to abide by those rules and any subsequent amendments. If any information is false or has been withheld I accept that this may cause cancellation of my enrolment and/or further consequences.
Student Signature *

Clear
Date *

Day Month Year
Date
FORM: STD09.014 Change Course/Course Location Request Form LAST UPDATE: June 2018, Version No. 7
Should be Empty: