USCHealth Withdrawal form

Withdraw Form
Relevant Standards

SRTO 2025: Outcome Standard 2

The National Code 2018: Standards 2.1.8, 9

Linked Documents

Course Completion within Expected Duration Policy

Students Complaints and Appeals Policy

Course Progress Interview Form

Student to complete the following sections:
Student ID*
Student Name*
Email*
example@example.com
Current Address
Course
Date of Withdrawal

DayMonthYear
Date
Reasons for Withdrawal *
Please provide as much details as possible. Note: Attach any supporting documents with this form if necessary
Moving to Another RTO/Institute/Uni ?*

Yes (Provide a copy of your “LETTER OF OFFER” from new provider)No (Provide documentary evidence of the reason(s) stated above)
Student Signature*
Date

DayMonthYear
Date
File Upload*

Cancelof
Should be Empty:

Withdraw Form