Deferment , Transfer and Course Withdrawal Form
The outcome of this form will be released in 2 weeks after submission is received.
Section 1 – Student Details
Name
*
Mr.
Mrs.
Miss.
Ms.
Prefix
First Name
Last Name
Student ID
*
USI Number
Gender
*
Male
Female
Other
Phone Number
*
-
Area Code
Phone Number
Email
*
Currently enrolled in
*
Please enter the name of the course you are currently enrolled in
Start Date
-
Day
-
Month
Year
Course 1 Start Date
End Date
-
Day
-
Month
Year
Course 1 End Date
Campus
*
Please Select
Parramatta George Street
Parramatta River Road
Parramatta Albert Street
Haymarket
Windsor
Section 2 – Change Details
I wish to apply for (please tick one)
*
Deferment of my course
Withdrawal from my course
Withdrawal Date
-
Day
-
Month
Year
Select the option for withdrawal
Change of Provider
Special Consideration
Non Satisfaction with the Lead college Support services
Non Satisfaction with the Training Services
Please briefly describe the reason you have decided to discontinue your studies.
*
Defer Start Date
-
Day
-
Month
Year
Date
Defer End Date
-
Day
-
Month
Year
Date
Defer to Date
-
Day
-
Month
Year
Please briefly describe the reason you have decided to defer your studies.
*
Supporting documents
*
Browse Files
Cancel
of
Provider Name
Signature
*
Submit
Print Form
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