Fillable Student Request to Cancel (Australian National University)

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Student Request to Cancel (Australian National University)

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Student Request to Cancel
1 | Page CMFRM0002 Student Request to Cancel 1.0
Students complete and submit this form to request their course be cancelled.
Student Details
Name:
USI:
Email Address
Postal Address:
Course Details
Course Code:
Course Name:
Cancellation
Choose the relevant cancellation request below
☐
I would like to cancel my current course as I want to re-enrol with ACCCO in a different course/funding
☐
I would like to cancel my current course for the following reason:
Student Declaration
By signing this declaration, you agree to the following:
I would like to cancel my current course
I acknowledge the fees I have accrued for my course as per the course fee details that I agreed to at
enrolment.
I understand that I will only receive a Statement of Attainment for units of competency that I have been
assessed as competent if my accrued fees are paid in full.
I confirm my postal address recorded above is correct
I can confirm my email address recorded above is correct
I acknowledge that my course is formally cancelled after this request is processed and I receive a cancellation
letter from ACCCO.
Signature: Date:
Note: Please submit this form to your trainer so they can action your request to cancel
Note: Submission of this form will not trigger cancellation of automatic payments. Contact ACCCO Finance on 1300 139 406
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Student Request to Cancel (Australian National University)

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Completed 23 September 2021

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