Change of Education Agent Request Form

Change of Education Agent Request Form
1. Student Details
Full name*
Student Number*
Date of Birth*

MonthDayYear
Date
Current Agent Company Name
Branch
2. Agreement to Change Agent
Does your current Agent agree to the Change of Agent?

YesNo
If No, please explain why you want to change your Agent:
(Required if No selected)
3. New Agent Details
Agent Company Name
Branch
Staff Name
Email Address
example@example.com
Work Phone
(Required)
Mobile Phone
(Optional)
4. Declaration
• I certify that I have notified my current Agent of my request to change to a new Agent. If my application is approved, Rosehill College will inform me, my current Agent, and my new Agent of the change.

• I understand that if I have already paid for my fees or part thereof, and received a Confirmation of Enrolment (CoE) for my current course of study, no change of Agent will apply for that course of study.

• My preferred new Agent must be one of Rosehill College’s registered Agents. A listing of Rosehill College’s registered Agents can be found on Rosehill College Registered Agents.
Applicant’s Signature

Clear
Date

MonthDayYear
Date
Parent or Guardian’s Signature

Clear
(if applicant is under 18 years of age)
Date

MonthDayYear
Date
Submission Instructions:
1. Fill out all fields completely. Incomplete applications may delay processing.
2. Submit this form online or email it to enrolments@rosehillcollege.edu.au.
3. Review Period: Allow up to 10 business days for a response.
Need Help? Contact the Admin Manager at info@rosehillcollege.edu.au or +61 (02) 7228 0008 for assistance.
Should be Empty:

Change of Education Agent Request Form

1. Student Details

2. Agreement to Change Agent

3. New Agent Details

4. Declaration