Academy of Workplace Learning RTO# 40603 | AOWL-017 | V1.0 | Sep 2024
Application to Withdraw/Discontinuing
Student Information
Student Name
First Name
Last Name
Email Address
example@example.com
Student ID
Contact Number
Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Trainer Name
First Name
Last Name
Course Withdrawal Request
I would like to terminate my current enrolment from (Please tick ALL the courses you would like to withdrawal)
CHC30121 - Certificate III in Early Childhood Education and Care
CHC33021 - Certificate III in Individual Support
CHC43015 - Certificate IV in Ageing Support
CHC43121 - Certificate IV in Disability Support
CHC43315 - Certificate IV in Mental Health
CHC50121 - Diploma of Early Childhood Education and Care
TLI30321 - Certificate III in Supply Chain Operations
Other
Reasons for withdrawal:
Student Declaration
Student Signature
Date
-
Month
-
Day
Year
Date
OFFICE USE
Has the student paid all outstanding fees?
Yes
No
N/A
APPROVED
NOT APPROVED
Staff Signature
Date
-
Month
-
Day
Year
Date
Continue
Continue
Should be Empty: