Forms - Variation of Enrolment

Student Details

Name*

Student Number*

Mobile*

Email address*

Please Withdraw me from the following Unit/s:

Unit Code	Unit Title	Study Period	Study Mode (Online / On-Campus / Intensive)

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There is a full refund of fees, and no academic penalty (graded as Withdrawn).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

Signature of applicant*

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