COURSE EXTENSION APPLICATION

COURSE EXTENSION APPLICATION
Important Information: Please note the student needs to discuss with the Academic Director before lodging the request. This form needs to be completed by the Academic Director during the discussion session.

Instructions
- This form is to be used for students who have been enrolled full time by Auscanus Institute of Australia and who are applying for a change of the existing enrolment.
- Incomplete forms will not be accepted.
- Application with no sufficient supporting documents (where applicable) will not be accepted/processed.
- Accurate information must be provided for the College to assess the application and correspond to student.
- The completed form and supporting documents must be submitted here.

Section 1 - Student Personal Details
Student ID*
Name*

Given NameFamily Name
Current Campus*
Current Course*
Mobile Number*
Email address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Section 2 - Course Extension Details
Course Name*
Start Date For Extension:*

DayMonthYear
End Date Of Extension:*

DayMonthYear
Number of unit(s) repeating:*
Name of unit (s) repeating: Unit Code*
Unit Name*
Unit Code
Unit Name
Unit Code
Unit Name
Reason For Extension*

intervention Strategy (Academic Director to check the intervention records)Compassionate and compelling grounds (Supporting documents must be submitted)Other (Please specify)
Academic Comments by Academic Director*
Academic Director Signature:*

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Date*

DayMonthYear

Section 3 - Student Declaration
- I declare that the information supplied by me on all parts of this form is correct and true.
- I understand that any false statement may result in
  - 1) The college notifying DHA about my false claims.
  - A charge of breach of discipline or academic misconduct made against me.
- I understand that the supporting documents must be submitted at the time of request lodgement.
- I understand the supporting documents I submitted must be true and genuine. The fraud documents may result in the breach of my student visa.
- I understand that the College will notify DHA of the change of my enrolment at Auscanus Institute of Australia, and this may affect the validity of my student visa.
- I understand that I must continue to attend class until I am notified of the outcome of my request and failure to attend class will result in being marked absent and affect my course progress.
- l understand that the assessment of my request will be based on the reasons and my supporting documents and on the College policies and procedures.
- I understand if my request is granted for course extension, change of course and change of campus:
  - Tuition fees may incur.
  - The duration of my enrolment may be varied.
  - I need to seek advice from DHA about any possible implications for my student visa; for instance, a longer period of enrolment than the expected duration may mean that I will need to apply to extend my student visa.
  - My course progress may be affected.
  - My timetable may change.
  - I must return to class when expected. If I do not, my enrolment and CoE will be cancelled as non-commencement, and this will put my student visa at risk.
- I understand that I will be issued a new Letter of Offer and a new Written Agreement (WA) for the changes and until the signed WA is received by the admissions department.
  1. The process of the request will not be finalised.
  2. New CoE will not be issued which could lead to my student visa at risk.
Student Name*
PRINT FULL NAME
Student Signature*

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Date*

MonthDayYear
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COURSE EXTENSION APPLICATION

Section 1 - Student Personal Details

Section 2 - Course Extension Details

Section 3 - Student Declaration