Deferment, Transfer and Course Withdrawal form.
Lead-Smart & Skilled
Student Full Name
*
Mr.
Mrs.
Miss.
Ms.
Prefix
First Name
Last Name
Student ID
*
USI Number
Gender
Male
Female
Other
Employer Name
First Name
Last Name
Address
Street Address
City
State / Province
Postal / Zip Code
Phone
*
Email
*
Email
*
Course ( Currently enrolled in )
*
Course Start Date
*
-
Day
-
Month
Year
Date
Course End Date
*
-
Day
-
Month
Year
Date
Campus
*
Please Select
Parramatta George Street
Parramatta River Road
Parramatta Albert Street
Haymarket
Perth
Windsor
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
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