Course Withdrawal Request Form

COURSE WITHDRAWAL REQUEST FORM

WA Government Subsidised Student: WA Fee Free Program
If you wish to withdraw from your course, please complete this application form and press the 'submit' button.

STUDENT DETAILS
Name*

First NameLast Name
Student number*
You can find this on the Equinim Learning HUB Home Page or in the email we sent to you when sharing this form.
Date of birth *

DayMonthYear
Date
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Address Line 2

CityState / Province

Postal / Zip Code

COURSE CANCELLATION
A refund of any fees paid, including any resource fee, will be issued in accordance with the WA Government VET Fees & Charges Policy, which is avaliable for download from our website. If you wish to terminate your studies before the completion of your course, you must notify EQC Institute using this form.

As you are enrolled under the Jobs and Skills Priority Industry Training Fee Free program, there is no student course fee applicable to your enrolment. Your enrolment was subsidised in full by the WA Government. EQC Institute did not charge a resource fee for your studies and therefore no refund is applicable to your course withdrawal.

We wish you all the very best with your future endeavours.

STUDENT DECLARATION
By signing below and pressing the 'submit' button, you declare that:
- I have read the conditions and declare that the information I have provided is correct and complete. I understand that any course cancellation must comply with the terms and conditions of enrolment as per the terms set out in the EQC Istitute Enrolment form and Student Agreement.
Signature*

Clear
Date*

DayMonthYear
Should be Empty:

COURSE WITHDRAWAL REQUEST FORM