ELICOS Holiday Request Form

Holiday Request Form

This form is for General English students ONLY
This form must be submitted online 2 weeks prior to the desired holiday dates.

Holidays must be taken in ‘a week format’ (Monday to Friday) and not by days.
Student Details
Students Full Name*

Given Name(s)Family Name
Student ID Number*
Date of Birth*

DayMonthYear
Contact Number*
Please enter a valid phone number.
Email Address*
example@example.com
Residential Address*

Street Address

Street Address Line 2

SuburbPost Code

State/Territory
Which level of General English are you currently studying?*
How many weeks of Holidays would you like to take?*
enter # of weeks
When would you like to take holidays?*

DayMonthYear
Holiday start date (must be a Monday)
DayMonthYear
Holiday end date (must be a Friday)
Mini Holiday Start Day

DayMonthYear
Date
The holiday start date needs to be a minimum of 2 weeks after the application date, or the {date}.
Why would you like to take holidays at this time?*
Will you be travelling overseas during the requested holiday period?*

YesNo
Please attach a copy of your flight tickets

Cancelof
Students Signature*

Clear
Date of Application*

DayMonthYear
Should be Empty:

Holiday Request Form