Change of Course Form

Change of a course form Page 1 of 1 Version 1.1; Last Updated on 19th April 2010 Document Uncontrolled When Printed Change of a course form STUDENT DETAILS Family Name: ________________________________________ Student No: _________________ Given Name/s: ________________________________________ Date of Birth: _____/_____/_____ Address in Australia: ___________________________________ State: _____ Postcode: _____ Mobile: __________________________ Email: _________________________________________ CURRENTLY ENROLLED/STUDYING COURSE Course Title:_____________________________________________________________________________ Start Date: _____________________ Date of Last Class Attended _______________________________ COURSE WISHING TO CHANGE TO Course Title: ____________________________________________________________________________ Requested Start Date: _______________________ I acknowledge that course change fee of $50 is payable immediately when applying. I acknowledge that changing from a course does not release me from any financial commitments I have previously agreed upon. I acknowledge that failure to pay my outstanding fees may lead to academic failure. I acknowledge that I may not be permitted to a course change in some circumstances.  I acknowledge that it is my responsibility to contact the College to determine my financial liabilities and the Principal regarding any academic issues. Signature of Student: Date: Approved by the Principal YES NO Signature: Date: …………………………………………………………………………………………………………………………… Student Receipt Student Name:………………………………….. Student No.:……………………………………………. Student Signature:……………………………… Student Services Staff Name:……………………….. Student Services Staff Signature:…………….. Date…………………………………………………….. For Office Use Only Application received by (Name): Signature: Date: All fee received: NO  YES Signature: Date: PRISMS updated: NO  YES Signature: Date: Database updated:  NO  YES Signature: Date: Confirmation letter sent: NO  YES Signature: Date:

Change of a course form Page 2 of 1 Version 1.1; Last Updated on 19th April 2010 Document Uncontrolled When Printed