Forms - Course Withdrawal

Student Details

Name*

Student Number*

Mobile*

Email address*

Enrolled through?*

Please withdraw me from the following course:

Course name:*

Reason for Withdrawal

Other reason for Withdrawal:

Further comments

Are you requesting a refund as part of this application?*

If withdrawing, please tick one box:

Withdrawing before Admin Date (Friday of Week 2)
Withdrawing before Census Date (1st Sem - 31st March, 2nd Sem - 31st August, 3rd Sem - see course unit outline for dates)
Withdrawing before Withdrawal Date (Friday of 2nd week after Census Date)
Withdrawing after Withdrawal Date (Friday of 2nd week after Census Date)

There is a full refund of fees, and no academic or financial penalty.

There is a full refund of fees/FEE-HELP adjustment, and no academic penalty.

There is no refund of fees/FEE-HELP adjustment, and you will receive "W" grade on transcript

There is no refund of fees/FEE-HELP adjustment, and you will receive "FW" grade on transcript.

If withdrawing, please tick one box:

Withdrawing before Census Date (before or on Friday of Week 2 - see course unit outline for dates)
Withdrawing after Census Date (after Friday of Week 2 - see course unit outline for dates)

There is a full refund of fees, and no academic penalty (graded as Withdrawn).

There is no refund of fees/VSL adjustment, and you will receive "Competency Not Achieved/Fail" on transcript.

I declare*

I have read the Vose Seminary and ACT Withdrawing from Studies Policy and Procedure and hereby confirm my understanding thereof. I understand that if I have chosen to make use of Commonwealth Assistance in the form of Fee-Help or VET Student Loans (VSL), and I have studied past the applicable Census Date, that I may have incurred a debt for that study. I understand that a final statement of my debts will be sent to me upon my withdrawal. I understand that personal and career counselling is made available to me at my choice upon my withdrawal. For units that I have successfully completed and for which have been paid in full, I understand that I will be eligible for a Statement of Attainment (VET) or statement of academic results (Higher Education).

Signature of applicant*

NB: ONLY the applicant may sign this form - no proxy signature will be accepted