eCoE Change Form (INT)

eCoE Change Form

This form is for student use.
Students' details
Full Name*

First NameLast Name
Student ID Number*
e.g. 000123
Date of Birth*

DayMonthYear
e.g. 21/05/1995
Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Details of eCoE change
Please select the course you are currently enrolled in*
eCoE Number*
What is the current eCoE status?*
What is the reason for the change?*

Change of courseCourse extension request (CoE Extension)Early commencement of courseEarly recommencement (after suspension)Other (please provide details below)
Other - Please provide details below*
Please select the course you would like to change in to*
Please explain the reason you are requesting the change(s) mentioned above*
Please attach any document(s) to support your application (optional)

Cancelof
By signing, I agree to the following:
- I have been advised by Original Campus to consult my Education/Migration Agent to ensure the changes do not affect my Student Visa
- The changes requested in this form will be reviewed by admin and I may be required to provide additional evidence
- All of the information I have provided is true and correct to the best of my knowledge
- Original Campus may refuse my request to change my coe at their discretion
- An administration fee of $250 applies prior to the change(s) being made
- I will be sent a copy of the Cancelled eCoE(s) and related documents
- The Cancelled eCoE(s) and related documents will be recorded in my student file
Full Name *

Given Name(s)Family Name(s)
Student's Signature*

Clear
Date*

DayMonthYear
Date Signed
Request type
Should be Empty:

eCoE Change Form

Students' details

Details of eCoE change