Application for Deferral, Suspension or Cancellation of Course

Application for Deferral, Suspension or Withdrawal

This form is for domestic students ONLY
STUDENT DETAILS
Student ID Number*
e.g. 000123
Date of Birth*

DayMonthYear
Given Name(s)*
Family Name*
Mobile Number*
e.g. 0412 345 678
Email Address*
e.g. johnsmith@gmail.com
Residential Address*

Building/Property Name

Street Number, Street Name (e.g. 123 Smith Street)

SuburbState

Post Code
COURSE VARIATION DETAILS
Please select your current course
Course Start Date*

DayMonthYear
Course End Date*

DayMonthYear
TO
Action Requested*

Defer Enrolment (before course commencement)Suspend Enrolment (during course)Withdraw Enrolment (after course commencement)
Period of Deferment/Suspension
NOT REQUIRED FOR CANCELLATION
WeeksMonths
Why are you making this request?*
Please explain in your own words
You are required to provide evidence/documents to suport your request. If you do not provide relevant evidence, your application may be refused.
Please upload evidence to support your application*

e.g. flight tickets, medical documents etc.
Cancelof
IMPORTANT INFORMATION

Deferment/Suspension of studies:

Original Campus will only grant a deferment or suspension of enrolment due to compassionate and/or compelling circumstances. Sufficient evidence to support the circumstances must be provided along with the application. Applications which do not have sufficient supporting evidence attached will not be accepted. (Please refer to the colleges Extenuating Circumstances table for more information on what may and may not be considered compassionate/compelling circumstances - you can request this document from the administration team)

Withdrawal from course:

You are permitted to apply for a Wtihdrawal at any time during your course.

If you have completed 1 or more units, you will be issued a Statement of Attainment for those units.

Should you wish to re-commence your course after Withdrawing, you will be required to complete a new application and pay the associated fees.

Withdrawing Post Cooling off period:

The Cooling-off Period is seven (7) calendar days from the date of receipt of payment of the Course Advisory and Enrolment Fees.
The Course Advisory and Enrolment Fees are part of the Total Course Fees.

Original Campus will provide the consumer with a full refund if Withdrawal occurs within the Cooling-off Period or Trial Period.

Withdrawing Post Cooling off period:

Any Student that makes a withdrawal request post Cooling-off period remains liable full course fees.

A student may be eligible for a partial refund under extenuating circumstances. In this case, the student must complete the Refund Request Form.

In all cases, Original Campus will retain the Course Advisory and Enrolment Fees.

If a student is eligible for a partial refund, it will be calculated on the following;
- The Course Advisory and Enrolment Fees portion of the Total Course Fees is not refundable.
- A pro-rata refund will be calculated based on the number of units remaining or the duration time remaining.
The lower of the two will be applied when calculating the partial refund.

A Student has the right to appeal any decision by completing the Complaints and Appeals Form.

Original Campus will adhere to the college complaints process.
Upon receiving the outcome from the Director of Studies, Original Campus will process a refund request within ten (10) business days.
Student Declaration:
- I declare that the above information is true and correct
- I acknowledge that providing incorrect information or withholding relevant information may delay the application or affect my enrolment at Original Campus
- I acknowledge that changes to my enrolment may affect the status and validity of my visa
- I understand that Original Campus must notify the relevant authorities within 14 days of any changes to my enrolment
- I understand that a decision will be advised in writing within 10 days of receiving this application along with all documentation requested by OC to assess my request. The request is not finalized until advised in writing by OC.
- I agree to continue to attend classes according to my schedule academic sessions while I’m waiting for a decision to be made on this request
- I have read and acknowledge the "Important Information" provided above
Student Signature*

Clear
Date*

DayMonthYear
Date of submission
OFFICE USE ONLY
Receiver Name:
Staff member name
Receiver Position:
Staff member position/role
Date received:

MonthDayYear
Is supporting evidence attached?

YesNo
Deferral Outcome
Are tuition fees paid up-to-date?

YesNo
Is the Request Approved?

YesNo - explain below
If the request has not been approved, please state why:
Date of Last Class Attendance (if approved)

DayMonthYear
Has the SMS been updated?

YesNo
Has PRISMS been updated?

YesNo
Has the student been notified of the outcome via email?

YesNo
New eCoE Number(s)
Separate with a comma if more than one - DOES NOT APPLY TO CANCELLATIONS
Approving Officer's Name
Approving Officer's Position
Approving Officer's Signature

Clear
Date of Approval

DayMonthYear
Please include any additional comments:
Should be Empty:

Application for Deferral, Suspension or Withdrawal

STUDENT DETAILS

COURSE VARIATION DETAILS

OFFICE USE ONLY

Deferral Outcome