Withdrawal from Studies Application Form

WITHDRAWAL FROM STUDIES APPLICATION FORM
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 students.
- The completed form and supporting documents must be submitted with your application.

Section 1 - Student Personal Details
AIA Student ID*
Student Name*

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Section 2 - Withdrawal from Studies Details & Supporting Documents
The student must make sure to read the below policies and procedure before lodging this request. Failed to read these policies will result in delayed outcome. These policies and procedures are avaiable on AIA website or CLICK HERE TO REVIEW NOW!

1. Deferring, Suspending and Cancelling Overseas Student Enrolment Policy and Procedure

2. Fees, Charges and Refund Policy and Procedure
Reason for Withdrawal*

MedicalFinancialFamilyEmploymentCourse not suitablePersonalTransfer to another AIA CourseEnrolling at another institution (if so, please specify Name below)
Please Select Below, which Course or Courses are you withdrawing from? *
Multiple Selections are allowed to be ticked
Withdrawal Date (I wish to withdrawal from my course effective from):*

DayMonthYear
Reasons for Request (please specify)*
Supporting Documents

Please make sure to upload the supporting documents to process the application further.
Cancelof

Section 3 - Student Declaration
I, an student of AIA declare that,*

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) AIA notifying DHA about my false claims. (2) 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 lodgment.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 AIA will notify DHA of the change of my enrolment at AIA, 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 AIA's policies and procedures.I understand if my request is granted for course extension, change of course and change of campus: (1) Tuition fees may incur. (2)The duration of my enrolment may be varied. (3) 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. (4) My course progress may be affected. (5) My timetable may change. (6) I must return to class when expected. If I do not, my enrolment and CoE or CoEs 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 (LOO) and a new Written Agreement (WA) for the changes and until the signed LOO and 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*

Clear
Date*

DayMonthYear
Please verify that you are human*
Should be Empty:

WITHDRAWAL FROM STUDIES APPLICATION FORM

Section 1 - Student Personal Details

Section 2 - Withdrawal from Studies Details & Supporting Documents

Section 3 - Student Declaration