STUDENT SUPPORT FORM
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Address Change for Domestic Student
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Completion Letter
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Reference letter
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General Feedback
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Student Name
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First Name
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Last Name
Student ID:
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Birth Date
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Gender
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N/A
Email
*
example@example.com
Contact Number
*
Mobile Number
Home Address in Australia
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Address Overseas
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Enrolment Status
*
Current
Enrolled (course not commenced)
Reference Letter
Release Request
Leave Request
Log-Book Request
Holiday Letter
Current Course Details
Course Information
Completion Letter
Enrolment Verification
Attendance Report Request
Complaint
Course
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Please Select
BSB10120 Certificate I in Workplace Skills
BSB10120 Certificate II in Workplace Skills
BSB30120 Certificate III in Business
CHC22015 Certificate II in Community Services
CHC33015 Certificate III in Individual Support
CHC43015 Certificate IV in Ageing Support
CHC43115 Certificate IV in Disability
SIT40422 Certificate IV in Hospitality
Course Name
If the above list does not include course, please type in
How would you like to receive the document? *
Collect in person at FNTC
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not applicable on my request
Start Date
*
-
Month
-
Day
Year
Provide start date of your leave of absence
Reasons for Request:
*
End Date
*
-
Month
-
Day
Year
Until when is your leave of absence
Reason for Leave of Absence
*
Please Select
Death in the family (Death certificate)
Family member has serious or severe illness (Medical certificate)
Involved in legal or court action (Police or Court Record)
Returning to home country (One way airline ticket)
Victim of a serious crime (Police Report)
Medical reason
Other
Date of Incident
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Month
-
Day
Year
Date
Course:
Type of Incident:
Complaint
Appeal
Assessment appeal
Did you receive a notice of intention from FNTC to report to Department of Home Affairs (DHA)?
Yes
No
Please attach the letter if you tick yes
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Details of Complaint/Appeal/Assessment Appeal
Did you discuss with your trainer to resolve the complaint?
Yes
No
Did you discuss with student services to resolve the complaint?
Yes
No
Please attach your supporting document if needed:
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Clear Fields
Current/Enrolled Course of Study:
Course Code:
Course Name:
New Course Request:
New Course Code:
New Course Name:
Reason for Request:
How would you like to receive the document? *
Collect in person at FNTC
Receive via Post
Receive Scanned Copy via email
Have you studied with us previously?
Yes
No
If yes, when was your last year of study?
Name of previous college?
Reason for leaving previous college?
Upload Statement of Attainment for all the units you are seeking Credit Transfer.
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Enrolment Variation Requested
*
Re-enroll
Suspend (current enrollment)
Transfer (to another course)
Cancel/Decline (enrollment)
Defer
Start Suspension Date :
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Month
-
Day
Year
Date
Return Date :
-
Month
-
Day
Year
Date
New course name
New Course Start Date :
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Month
-
Day
Year
Date
Cancel Decline From Date :
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Month
-
Day
Year
Date
Deferment Start Date :
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Month
-
Day
Year
Date
Deferment End Date :
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Month
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Day
Year
Date
Please provide your reasons in details:
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Please attach supporting document here:
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Feedback:
Date
-
Month
-
Day
Year
Date
Enrolment & Withdrawal Details
Qualification Code:
Qualification Title:
Fees Paid in amount:
Fee Payer Name:
Address:
Select one of the following options
Withdrawal from course
Withdrawal from units of study on or before census date (no debt incurred or refund given if payment has been made)
Withdrawal from units of study after census date (no refund given/debt still incurred unless special circumstances apply)
Reason for Withdrawal
Units of Competency (For Withdrawal)
Unit Code
Unit Title
1
2
3
4
5
6
7
Refund Details
Refunds are payable to the Fee Payer nominated above. Where payments have been made by credit card, refunds can only be issued to the original credit card number. For electronic transfer of funds, please complete details below:
Account Name:
Bank Name:
Branch:
BSB Number:
Account Number:
I hereby acknowledge that I have been provided with details of the FNTC Fee and Refund Policy and the information provided in this form is true and correct
*
I understand that if my course has already commenced, I will be provided with refund based on the refund policy stated within offer letter at the time of my enrollment.
*
Please upload all the relevant files :
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Student Declaration
*
I declare that the information I have provided to the best of my knowledge is true and correct.
I understand that giving false or incomplete information may lead to the refusal of my application
I have read and understood FNTC Policies that fees may apply in processing this application.
Signature
*
Date
-
Month
-
Day
Year
Date
Submit
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