Fillable Family name Given name Postal address Postcode Course (Australian Correspondence Schools)

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Family name Given name Postal address Postcode Course (Australian Correspondence Schools)

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Withdrawal Application Form – V1 December 2020
SECTION A: STUDENT TO COMPLETE. PLEASE RETURN THIS FORM TO YOUR CAMPUS OF ENROLMENT
Family name Given name
Student number Campus name
Date of birth Course number Cal-occ code (Staff Use only)
Postal address Postcode
Course name
Course fee paid $ Paid by: Student Other If other, please provide payer details below
Payer full name (Company/Individual)
Address Postcode
I wish to apply for a withdrawal because I am (please tick one and provide reason):
Discontinuing my studies
Transferring to another Training Provider
Staff use only - Staff initiated withdrawal. Customer Contact Form attached/recorded and participation/results finalised.
Reason for discontinuing/transfer:
I wish to apply for a refund/partial refund because (please tick one)
I am withdrawing prior to the Course Start Date (at least 5 business days prior where course duration is 1 week or less)
I am withdrawing after Course Start Date (discontinuing studies with TAFE NSW and with pre-paid future fee instalments)
Other (please specify and attach evidence)
Not applicable
SIGNATURE OF STUDENT
Note for Students: Submitting this application via your TAFE NSW email account is recognised as your electronic signature
SECTION C: STUDENT SERVICES OFFICE USE ONLY
*Withdrawal effective date (see note 3)
Student is refund eligible and Student Fee Refund Form sent? Yes No
Refund Reason: N/A WDAC WDBC Other
SIGNATURE Recommending Officer Date:
Withdrawal code entered
Signed Date:
Transcript/Employer Report/Withdrawn Award printed
Signed Date:
forwarded to: Library
Signed Date:
WITHDRAWAL APPLICATION FORM
SECTION B: TEACHING SECTION TO COMPLETE
Last participation date
Customer Contact Form attached or contact methods recorded in the student management system
(evidence of contact for staff-initiated only)
Participation and results finalised in student management system
STAFF NAME
STAFF SIGNATURE
Date
Date
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Withdrawal Application Form – V1 December 2020
TAFE NSW training, including Smart and Skilled
WITHDRAWING FROM YOUR STUDIES
Students who withdraw are required to notify the campus/Region in writing.
If you are withdrawing
• before the Course Start Date, you will be eligible for a refund of your Student fee or Concession fee (*See Note 1).
• after the Course Start Date, you may be eligible for a partial refund of your fee.
• If you are withdrawing from your studies you will be asked to identify if you are discontinuing your studies or transferring to another Registered
Training Provider.
Note 1:
For courses of 1-week duration or less, the student must advise withdrawal at least five (5) business days before Course Start Date.
Note 2
:
Written notification of the student’s intent to ‘withdraw/discontinue’ their studies is either by this form completed by the student, or this
form completed by a staff member with supporting evidence of student’s request, except as per Note 5 there is/has been no contact with the
student.
Note 3
:
Withdrawal effective date is when the student provides formal notification to TAFE NSW of their intention to withdraw, as per note 2.
Note 4:
A Fee Notification will be provided to the student for any fees that remain outstanding at the time of withdrawal. Where payment is not made by
the due date, TAFE NSW may take action to refer the amount to an agency for collection.
Note 5:
TAFE NSW will take action to withdraw students from study where:
• Students have not demonstrated participation and/or attendance in their study on a regular basis.
TAFE NSW will attempt contact to determine their status of continuing enrolment or withdrawal from their studies.
TAFE NSW will assist students to re-commence studies, however if no response is received within times specified, action will be taken to
withdraw/close the enrolment.
• The student cannot demonstrate competency in all applicable practical/theory/workplace c
omponents of study.
TAFE NSW is under no obligation to offer repeat attempts at a Unit of Competency or continue an enrolment where competency is not
demonstrated.
FEE REFUNDS
Refund of your fee to be given in the following circumstances:
• You enrolled in a course/qualification that has been cancelled by the campus or TAFE NSW.
• You have overpaid the Student fee or Concession fee.
• You have paid the Student fee or Concession fee and are then granted a fee exemption – refer to Fee Exemption Application Form
• You formally advise the campus of your withdrawal, prior to the Course Start Date.
• Where the course duration is 1 week or less, you formally advise the campus of your withdrawal 5 business days before the Course Start Date.
• You formally advise the campus of your withdrawal after the Course Start Date and you have pre-paid your Student fee for future-dated fee instalments
as per the fee instalment schedule of your enrolled course/qualification.
Note 6: ‘Other circumstances’ for a fee refund includes where your course is cancelled or you have overpaid your Student fee or Concession fee.
In these circumstances, you will not be required to complete or sign the refund application, however we will contact you regarding Credit/Debit card
and/or bank details to process a refund payment.
Note 7: Refunds are to be made to the student, organisation or third party who originally paid the relevant fee.
Note 8: There are no refunds for incidental fees
Note 9: Original payment via Credit/Debit Card and refund requested to that same card requires the first six (6) and last four (4) card digits to be
obtained at the time the refund is processed. If you are entitled to a refund, a TAFE NSW Staff member will be in contact with you shortly to securely
obtain information related to your Credit/Debit card or bank details.
Note 10: TAFE NSW will not ask for your full Credit/Debit card number at any time.
STUDENT PRIVACY
Information collected by TAFE NSW (the New South Wales TAFE Commission) during a student`s enrolment and attendance will be used for the
purposes of student record administration, identification, communication, state and national reporting, program monitoring, evaluation and surveys.
Student information will be held securely and disposed of securely when no longer needed.
The information may be disclosed when required by law and to government departments and agencies, including for example to Services Australia
(Centrelink), the Department of Home Affairs, Transport for NSW, NSW Department of Education, the Australian Skills Quality Authority, the Tertiary
Education Quality and Standards Agency, the Universities Admission Centre, Board of Studies Teaching and Educational Standards NSW and the
National Centre for Vocational Education Research. In order to meet the requirements of Registered Training Organisations under the Apprenticeships
and Traineeships Act 2001, apprentice and trainee information is provided to employers, Australian Apprenticeship Centres and Training Services NSW
(or the relevant State Training Authority).
While the provision of the information requested on this form is not required by law, it is a requirement of TAFE NSW and your enrolment will not be
accepted if it is not provided. You may correct your personal details by contacting your TAFE NSW campus administration or by using the TAFE NSW
Student Portal. Refer to https://www.tafensw.edu.au/privacy
for more details.
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Completed 21 March 2021

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