Support Services Request Form
Section 1: Personal Information
Full Name
Student ID Number
Email Address
example@example.com
Phone Number
Program of Study
CHC30121 Certificate III in Early Childhood Education and Care
CHC50121 Diploma of Early Childhood Education and Care
BSB50120 Diploma of Business (Digital and Data)
BSB60420 Advanced Diploma of Leadership and Management
BSB80120 Graduate Diploma of Management (Learning)
BSB50820 Diploma of Project Management
BSB60720 Advanced Diploma of Program Management
ICT50220 Diploma of Information Technology (Business Analysis)
ICT60220 Advanced Diploma of Information Technology
BSB40820 Certificate IV in Marketing and Communication
BSB50620 Diploma of Marketing and Communication
BSB60520 Advanced Diploma of Marketing and Communication
General English
Section 2: Type of Support Required
Type of Support
Academic Support
Personal Counseling
Financial Support
Disability Support
Health and Wellness
Language Support
Other (Specify)
If Other, Please Specify
Describe the Support Needed
Section 3: Preferred Support Method
Preferred Method of Support
In-Person
Online
Phone
Preferred Contact Time
Section 4: Upload Supporting Documents
Please upload any relevant documents to support your request (e.g., medical certificates, financial statements, academic records).
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Section 5: Agreement to Terms
Agreement to Terms
I have read and agree to Rosehill College’s policies regarding the provision of support services.
Consent to Data Processing
I consent to the collection and processing of my personal data as described in Rosehill College’s Privacy Policy.
Signature
Date
-
Month
-
Day
Year
Date
Section 6: Additional Information
Additional Comments or Requests
Submit
Should be Empty: