General Support Request Form
Student Details
Name
*
First Name
Last Name
Student ID
*
Date of Birth
*
/
Day
/
Month
Year
Mobile Number
*
-
Country Code
Phone Number
Email
*
example@example.com
Address:
*
Course:
*
Course Start Date
*
/
Day
/
Month
Year
Back
Next
Request Details
Please tick the type of request:
*
Academic Support
Language Support
Accommodation Support
Extra Classes
Document Request (Enrollment Letter, Term Break letter, Copy of Document, etc)
Other
Please describe your request in detail below (attached supporting document where possible)
*
Upload Supporting Documents
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Acknowledgement
*
I understand that Omni College will contact me if more information is required.
I have read the fees and charges policy and I am aware of the extra charges involved for my request.
Signature
*
Date
*
/
Day
/
Month
Year
Date
Section 3 - Finance Approval (Office Use Only)
Request approved by finance:
Yes
No
N/A
Comments / Reason for decision
Print Name:
Position
Signature
Date Processed:
-
Day
-
Month
Year
Date
Admin Use Only
Formal Letter/Email Sent:
Yes
No
Sent by:
Date
-
Day
-
Month
Year
Date
Signature
SMS Updated:
Yes
No
Updated by:
Date
-
Day
-
Month
Year
Date
Signature
Continue
Continue
Should be Empty: