Course Deferment Application Form

COURSE DEFERMENT APPLICATION FORM

Important Note(s):
- Deferment enables students who have gained entry to our course, but who have not yet commenced study, to delay starting the course.
- DHA has discretionary power to cancel a Student visa where we defer the studies of a Student visa holder because of the student's conduct or our approval is based on fraudulent /misleading evidence relating to the deferral.
Part A. Personal Details:
Student ID:*
First Name:*
Family Name:
Date of Birth:*

DayMonthYear
Gender:*

MaleFemale
Mobile Number:*
Email Address:*
Address:*

Street Address Line 2
Part B. Course Details:
Current Course Name:*
Group No:
Course Start Date:*

DayMonthYear
Proposed Finish Date:*

DayMonthYear
Part C. Request Details:
Reason for Deferment:*
Start Date of Leave of Absence:*

DayMonthYear
End Date of Leave of Absence:*

DayMonthYear
Please specify the reason for requesting for the Deferment:*
Attached Itinerary/Medical letters/supporting documents for your request:*

Cancelof
Part D. Student Declaration:
I understand that:
- That this is a request for leave of absence and that the application will be considered in accordance with the College’s Deferment Policy
- I will be informed of the outcome of this request including the reasons for the outcome
- I understand the implications for my student visa
- I have attached all required supporting documentation
- I will notify the Institute in writing if my circumstances change and/or I will not be recommencing my studies immediately following the period of approved leave at least 28 days before the approved end date of Leave of Absence.
- The Leave of Absence applied for does NOT exceed one semester.
- My Deferment will be reported to DHA as per Government Policy. This can affect my student visa and I am aware I need to contact DHA on 131 881 if I need more information on this.
Student Signature:*

Clear
Date:*

DayMonthYear
Should be Empty:

Part A. Personal Details:

Part B. Course Details:

Part C. Request Details:

Part D. Student Declaration: