WIA - Change of Course or Course Location Request Form

CHANGE OF COURSE/COURSE LOCATON 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. Warwick 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 NameFamily Name
Course Name*
Student ID*
Phone Number*

Area CodePhone Number
Email Address*
example@example.com
Address*
COURSE INFORMATION:
Course Offered / Enrolled in*
Campus*
Start Date*

DayMonthYear
Date
Requested Course*
Campus*
Date*

DayMonthYear
Date
Reason(s)*
Attach Payment Receipt here:

Cancelof
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*

DayMonthYear
Date

CHANGE OF COURSE/COURSE LOCATON REQUEST FORM