Variation to Enrolment Form

Variation to Enrolment Form

Before completing this form, please read the Barrington Training Services Course Transfer, Extension and Deferral Policy
Type of Request?
Student Details:
Full Name

First NameLast Name
Unique Student Identifier (If you cannot remember your USI, please visit www.usi.gov.au and log in to the USI Registry System)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
E-mail
example@example.com
Current Course Details:

(Please enter the details of your current course)
Current Course Code
Current Course Title
Current Course Start Date

MonthDayYear
Date
Mode of Delivery
New Course Details:

(Please enter the details of the course you wish to transfer to)
New Course Code
New Course Title
Requested Start Date

MonthDayYear
Date
Preferred Mode of Delivery
Reason for Transfer:
Reason for Deferral (Select One):
Reason for Extension (Select One):
Reason for Withdrawal (Select One):
Please provide details of your reason for transfer/deferral/extension/withdrawal if not listed above:
Withdrawal Request Date

MonthDayYear
Date
Have you been granted a deferrment or extension previously for this enrolment? (Select One):
Please attach any relevant supporting evidence (E.g. Medical Certificate, Employment Letter, other)

Cancelof
Student Declaration
I understand that transferring courses may impact my course duration, fees, funding/subsidy eligibility, and training plan. I have read the RTO's course transfer policy, understood these implications and wish to proceed with this request.
I understand that deferring my course may affect the overall duration of my training, eligibility for government funding/subsidies, and future training schedule. I agree to abide by the RTO’s deferral policy and return within the agreed timeframe or notify the RTO of any changes.
I understand that an extension may affect my course timeline, potential government funding eligibility, and assessment deadlines. I have read the RTOs course extension policy and agree to any updated training schedule and requirements if this request is approved.
I confirm my intention to withdraw from the course listed above. I acknowledge that I have read and understood the RTO’s withdrawal and refund policy, and I am aware of any impacts on government funding, future training or qualification completion. I authorise the RTO to process this withdrawal.
Student Signature
Date

MonthDayYear
Date
Privacy Statement
The personal information supplied and collected in this Form is subject to the Privacy Act 1988 (Commonwealth) and will be treated in accordance with BTS’s Privacy Policy. A full copy of BTS’s Privacy Policy is available on our website.
RTO Use Only
Type of Request Submitted
RTO Use Only
Student Interview Conducted?
Academic Progress Reviewed?
TRANSFER Assessed for Suitability (e.g. LLN, prerequisites?)
DERFERRAL Eligibility for Deferral Confirmed?
RTO Notes
Decision
Conditions (if applicable)
Deferral Return Date

MonthDayYear
Date
Extension End Date

MonthDayYear
Date
Withdrawal Effective Date

MonthDayYear
Date
RTO Signature
Date

MonthDayYear
Date
Name and Position Title
Should be Empty: