CERTIFICATE REQUEST FORM

CERTIFICATE REQUEST FORM
Certificates/Statement of Attainment issuance may take up to 30 days.

Certificates can only be issued after you clear all outstanding fees and achieve satisfactory result in all required units.

Statement of Attainment can only be issued if:
- You have discontinued your studies with your current qualification.
- You are enrolled in your second qualification, but not meeting requirements for Certification issuance.
- All outstanding fees are paid.
Please check fees and charges list for urgent processing fees.

You must provide your Unique Student Identifier (USI) to the College before applying for the certificate/SOA.
I fully understand: *

Understand purpose of this formUnderstand which information will be required from me prior submitting applicationUnderstand that all my details will not be shared outside of the organisation
Student Signature:*

Clear
Date

DayMonth Year
Date

COURSE INFORMATION
COURSE COMPLETED*

Course Code Course Name
Do you need these documents urgently?*

YES – fees may be applicable*NO
* Please be advised if your results haven't been finalised in Canvas or Student Management System, fees may apply.
Did you provide your USI to the college?*

YESNO - you may not receive the certificate unless you provide us with your USI.
Date

DayMonth Year
Date
Student’s acknowledge of pickup (signature):*

Clear

OFFICE USE ONLY

[The following sections are ONLY for STAFF members to complete. Students must not complete this section]
Student has outstanding fees

YES – Do not issue any documentsNO – Submit form to academic check
Authorised Officer Name:
Signature:

Clear
ACADEMIC CHECK

Student results verified and assessments verified
Student is competent in all units?

Yes – print documentsNo – do not print
Should be Empty:

STUDENT INFORMATION