Deferring, Transferring or Discontinuing Form
Lead-Smart & Skilled
Student Full Name
*
Mr.
Mrs.
Miss.
Ms.
Prefix
First Name
Middle Name
Last Name
Employer Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone
*
Email
*
Course
*
Course Start Date
*
-
Month
-
Day
Year
Date
I Wish to
*
Apply to defer my course studies
Length of deferment? (maximum 12 months only)
Transfer my course to another provider
Reason for transfer
Withdraw from my course studies
Reason for course cancellation
Further Comments
Student Signature
*
Date
-
Day
-
Month
Year
Date
Administration Use Only
Deferral Approved
Yes
No
Processing Completed(See Overlay)
Yes
No
Comments
LEAD College Authorised Person
Name
Signature
Submit
Print Form
Should be Empty: