Apsley College Course Variation Form

1

Student ID Number* This field is required.

2

Full Name* This field is required.

First Name

Last Name

3

Home Address* This field is required.

Street Address

Street Address Line 2

City

State

Post Code

Country

4

Mobile Number* This field is required.

5

E-mail Address* This field is required.

example@example.com

6

Current Course* This field is required.

7

Start Date* This field is required.

Date

8

End Date* This field is required.

Date

9

Variation Request* This field is required.

Course Change ($250)

Course Deferment ($250)

Extension ($250)

Leave of Absence ($200)

Early Study Completion ($1000)

Withdrawal ($500)

10

{variationRequest} Start Date* This field is required.

Date

11

Leave of Absence Start Date* This field is required.

Date

12

Leave of Absence End Date* This field is required.

Date

13

{variationRequest} End Date* This field is required.

Date

14

Withdrawal Effectivity Date* This field is required.

Date

15

Early Study Completion Date

Date

16

New Course* This field is required.

17

Reason for {variationrequest}* This field is required.

VISA Type Change

VISA Application Refusal

Provider Transfer

Medical Issues

Returning to Home Country

Other

18

Please provide more details to support your request* This field is required.

19

Supporting Documents* This field is required.Provide documentation in English that will help support your case

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

20

Payment of Fees* This field is required.Kindly upload your receipt/s here

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

21

Application Date

Date

22

Student Declaration* This field is required.

23

Student Declaration* This field is required.

24

Student Declaration* This field is required.

25

Student Declaration* This field is required.

26

Student's Signature* This field is required.

Clear

27

Task Name

28

Task Notes

29

Admissions

example@example.com

30

Leave

example@example.com

31

Course Progress

example@example.com

32

Assignee

example@example.com

33

Due Date

Date