Change of Course Request Form
Student's Details
Student's name (as shown on passport)
*
First Name
Last Name
Student ID
Current Course
*
Please Select
General English
English for Academic Purposes
Cambridge English C1 Advanced
IELTS Target 6&7
High School Preparation
Course Request
*
Please Select
General English
English for Academic Purposes
Cambridge English C1 Advanced
IELTS Target 6&7
High School Preparation
Course Information
Current course title
*
Please Select
General English
English for Academic Purposes
Cambridge English C1 Advanced
IELTS Target 6&7
High School Preparation
Start date
*
/
Day
/
Month
Year
To be a "MONDAY"
End date
*
/
Day
/
Month
Year
To be a "FRIDAY"
New course title
*
Please Select
General English
English for Academic Purposes
Cambridge English C1 Advanced
IELTS Target 6&7
High School Preparation
Proposed start date
*
/
Day
/
Month
Year
To be a "MONDAY"
Proposed end date
*
/
Day
/
Month
Year
To be a "Friday"
Reason(s) for transfer:
*
In the space below tell us the reasons why you want to change your course
Declaration:
I declare that the information I have provide in this form is accurate and truthful.
I understand that any changes to my course of study may have an impact on my student visa.
I understand that a change of ELICOS course will result in a change in my CoE and that a change in CoE may result in
additional fee of $50 that must be paid before my transfer is approved.
Students signature
*
Date
/
Day
/
Month
Year
Date
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