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SADM1937
In providing my personal information to the University, I understand that, other than as authorised by law, the University will only use this information for the purposes for which it is being collected in accordance with the University’s
functions and activities associated with my enrolment. In some instances, the University may need to disclose information to any Government department which administers or has authority regarding education or immigration policy
and law and any other Government agencies (State, Territory or Federal, an affiliated entity of the University, or to third parties for the purposes of recovering unpaid University fees or other debts owed to the University, and I consent
to such disclosure. I also understand that all information will be collected, stored, accessed and disseminated or destroyed in accordance with privacy, records management and other relevant laws, and the University’s policies.
STUDENT ADMINISTRATION
DISCONTINUATION OR BREAK FROM STUDIES
STUDENT CENTRAL
LOCKED BAG 1797, PENRITH NSW 2751
Complete this form in BLACK INK using CAPITAL LETTERS and carefully read the information on page two before you start.
Submit this form to: - apply for a leave of absence (to take a break) from study (fill in section 2A only)
- discontinue (drop out of) units after census (fill in section 2B only)
- resign from your course at Western Sydney University (fill in section 2C only)
2B - DISCONTINUE (DROP OUT OF) UNITS AFTER CENSUS
You will automatically be awarded an ‘E’ (fail discontinued) grade for each of the units you list below. You must complete a Withdrawal
Without Academic Penalty Application form if you want to apply for your ‘E’ grade to be changed to a ‘W’ grade.
Teaching session Unit number Unit name
2A - LEAVE OF ABSENCE (TAKING A BREAK FROM STUDY)
Year to start leave:
Y Y Y Y
Session to start leave: Total leave duration:
NUMBER OF MONTHS
Session/s to have o study (choose the relevant teaching session/s for your course)
Standard teaching sessions (6 months per session)
most undergraduate, some postgraduate and teaching (1H and 2H)
Quarters (3 months per session)
some honours and postgraduate
Terms (4 months per session)
The College students only
Autumn 1H Q1 Q3 T1 T3
Spring 2H Q2 Q4 T2
REASON FOR LEAVE - STUDENT VISA HOLDERS ONLY
If you are a student visa holder, you can only request a Leave of Absence in compelling (e.g. academic) or other extenuating
circumstances and you must have this form signed by the appropriate sta member.
Academic reasons
must be signed by your Director of Academic Program (DAP)
Other extenuating circumstances*
must be signed by the Student Welfare Service
Units not available (e.g. units not on oer, timetable clash)
Medical
Other academic reasons (give details below)
Other extenuating circumstances
*Supporting documentation must be supplied
DAP OR Student Welfare Service DAP OR Student Welfare Service Date
NAME SIGN HERE
D D / M M / Y Y Y Y
1 - PERSONAL DETAILS
Student ID number Daytime phone number Are you a student visa holder?
Yes No
Title Family name
Given name(s)
Course code Course name Mode of study
Full time Part time
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2C - RESIGNATION FROM COURSE - INTERNATIONAL STUDENTS ONLY
Domestic Students (Australian Citizens and Permanent Residents, plus NZ Citizens) can request to discontinue their course through
MySR under Course Records.
Specify the date you wish to resign from this course:
REASON FOR RESIGNATION
Accepted another Western oer English Proficiency Health reasons Took up employment instead of study
Accepted oer at another uni Excessive study load Location issues Transport reasons
Course not suitable Financial reasons Personal issues Work commitments
Other reasons:
STUDENT VISA HOLDERS ONLY - this section must be signed by the Student Welfare Service or a SEIS International Liaison Ocer (SILO)
Student Welfare Service/SILO Student Welfare Service/SILO Date
NAME SIGN HERE
D D / M M / Y Y Y Y
Date received
3 - DECLARATION AND SIGNATURE
I declare that I have read and understood the instructions below. Please amend my University records to show
that I am changing my enrolment as indicated above.
Student’s signature
SIGN HERE
Date:
D D / M M / Y Y Y Y
IMPORTANT INFORMATION
Applying before and after census dates
Applying before the census date: If you submit a request for Leave of Absence (LOA) or Resignation on or before the relevant census date, you will not be liable for
any tuition fees, for any units you were enrolled in. If you wish to discontinue units before census, do so through MySR.
Applying after the census date: If you submit a request to discontinue units, resign or apply for a LOA after the census date, you will receive E grades (failed -
discontinued) for any enrolled units. You will also be liable for any tuition fees for these units. If you paid your fees up front for the session you will not be entitled to
a refund.
If you have submitted a request due to extenuating circumstances, you have the option of submitting a Withdrawal Without Academic Penalty Application. If your
application is successful, you will be given ‘W’ grades for these units and you will not be liable for the tuition fees. This tuition fee credit will be applied to your
tuition fees for the next session. For more information see westernsydney.edu.au/droppingunits.
Information on census dates can be found at westernsydney.edu.au/census.
Policies
LOA, resignation and discontinuing units after census are covered by the University’s Enrolment policy, available at westernsydney.edu.au/policy under ‘E’ in the
policy list.
Additional Leave of Absence (break from study) information
To be eligible for a LOA you must have been enrolled in one or more units past the census date for your first session of study. If you have been suspended or
excluded from Western Sydney University, you are not eligible for LOA.
Maximum period of leave: You are allowed to take a maximum of 12 months LOA from your course. If you need to take additional LOA, you will need to provide
supporting evidence with your application, as well as written approval from your Director of Academic Program or Academic Course Advisor.
Returning from leave: We will send you an email to advise when enrolment for the next session has opened. You will need to log into MySR and enrol in units for
that session. If you do not enrol by the census date of that session, you will be deemed to have abandoned your course of study. This means that you will need to
apply for re-admission through the Universities Admissions Centre (UAC) or International Admissions if you wish to resume your studies in the future.
Lodging this form
Please lodge this form at any Student Central, or post to: Student Central, Western Sydney University, Locked Bag 1797, PENRITH NSW 2751
Higher Degree Research students
To apply for a LOA, please refer to westernsydney.edu.au/research/research_candidates/forms. If you want to resign from your course you will need to submit a
written request to the Graduate Research School.
International students - student visa holders
LOA: Standard 13 of the ESOS National Code aei.gov.au/AEI/ESOS/NationalCodeExplanatoryGuide/PartD/Standard_13.htm requires that a LOA can only be
considered for you under ‘compassionate or compelling’ circumstances, and cannot (generally) be granted retrospectively. You must attach documentary evidence
to this application and understand that your application may be refused.
Discontinue: Please note, discontinuing units or reducing study load at any time may delay course completion. If you are studying less than a full time study load,
you must complete an Approval for Reduced Study Load application form.
Resignation: If you resign, this will ultimately lead to your visa being cancelled. Within a month of resigning, you must either:
(a) leave Australia or
(b) lodge a valid application for a new visa
If you plan to study at another Australian education provider after resigning from Western Sydney University, please note that there are important restrictions for
student visa holders. See westernsydney.edu.au/internationaltransfers for details of these restrictions.
D D / M M / Y Y Y Y
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