WIA - Document Request Form

DOCUMENT REQUEST FORM
Please note that the requests can only be processed if payments are up to date. Request for transcripts/qualifications will be available within 30 calendar days from completion date. Please note all the documents request will take up to 10 working days from submission of this form. Optional: A charge of $50.00 will be applied for URGENT processing. (3 working days from the request)
STUDENT DETAILS:
Name*

First NameFamily Name
Student ID*
Contact Number*

Area CodePhone Number
Address*
Email Address*
example@example.com
Course Name*
DOCUMENT REQUEST:*

Certificate/Transcript (Re-issue fee $50.00 Course completed ONLY)Completion Letter (Re-issue fee $50.00 Course completed ONLY)Statement of AttainmentInterim TranscriptConfirmation / Reference LetterAttendance Certificate*Other
Reason/s (Valid reason and supporting document/s are required)*
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
I confirm that I have received the requested document(s).
Student Signature

Clear
Date

DayMonthYear
Date
OFFICE USE ONLY

DOCUMENT REQUEST FORM