Fillable lease provide payer details below Address Pos Pa (Australian Correspondence Schools)

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Withdrawal/Refund Application Form - Latest Version V2.2 | 2020
WITHDRAWAL/REFUND APPLICATION FORM - 2020
SECTION A: TO BE COMPLETED BY STUDENT. PLEASE RETURN THIS FORM TO YOUR CAMPUS OF ENROLMENT
First name
Campus name
Cal-Occ Code
Family name
Student number
Date of Birth Course Number
Postal address
Pos
tcode
Course name
Course fee paid $ Paid by: Student Other
If other, p
lease provide payer details below
Pa
yer Full Name (Company/Individual)
Address
Postcode
I wish to apply for a withdrawal because I am (please tick one and provide reason):
(Note 5)
Deferring my studies for months
(max
. 12 months including previous deferral periods)
Disconti
nuing my studies
Transferring to another Training Provider
Staff use only - Staff initiated withdrawal. Customer Contact Form attached/recorded and participation/results finalised
.
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)
Date day
month
year
Note for Students: Submitting this application via your TAFE NSW email account is recognised as your electronic signature
SIGNATURE OF APPLICANT
(or staff member for staff
initiated withdrawals)
(STAFF MEMBER NAME)
Last participation date
Branch
Electronic Payment of Refunds: p
lease provide the payee bank account details.
Account Name
Bank
BSB No.
Account No.
SECTION B: OFFICE USE ONLY
Original Course Fee $ Amended fee $ RPL/Credits applied $
Payments received $ Instalments due by withdrawal $ Refund Due $
Refund Reason:
WDAC WDBC RPL/CT Granted Other circumstances *Withdrawal effective date
(see reverse of form)
SIGNATURE Recommending
Officer (Teacher/Head Teacher for
deferral applications)
Date:
day
month
year
No
Comments/reason for non-approval
Date: day month year
Approved Yes
SIGNATURE of APPROVER
(Delegation under 12.3 (b)
for refunds)
Withdrawal code entered Signed Date:
Refund/fee amendment details entered/Credit note raised Signed Date:
Transcript/Employer Report/Withdrawn Award printed Signed Date:
forwarded to: Section Library GovConnect Signed Date:
Note 1. Third Party Payment bank details will be verified by GovConnect when processing a refund.
Reason for deferral/discontinuing/transfer:
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Withdrawal/Refund Application Form - Latest Version V2.2 | 2020
TAFE NSW training, including Smart and Skilled
WITHDRAWING FROM YOUR STUDIES
Students who withdraw from a qualification are required to notify the campus/Region in writing
• If you withdraw from your qualification before the Course Start Date you will be eligible for a refund of your Student fee or Concession fee.
• If you are withdrawing from your qualification 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 deferring your studies, 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 5 business days before Course Start Date.
Note 2: Written notification of the student’s intent to ‘withdraw/discontinue’ their studies is by either this form completed by the student, or this
form completed by a staff member with supporting evidence of student’s request, except where there is no contact with the student as per Note 3.
Note 3: Students who have not demonstrated participation and/or attendance in their study on a regular basis will be contacted to determine their
status of continuing enrolment or withdrawal from their studies. TAFE NSW will assist you to re-commence your studies, however if no response is
received within times specified, action will be taken to withdraw you from your enrolment.
Note 4: Withdrawal effective date is when the student notifies TAFE NSW of their intention to withdraw, as per note 2.
Note 5: Student fees must be in balance at the time of withdrawal or deferral. Where outstanding fees prevent completion of the transaction, a fee notice
must be sent to the student.
DEFFERING OR DISCONTINUING YOUR STUDIES
Students who advise they are withdrawing from a qualification after participation in or commencement of studies will be asked to identify if they are
deferring their studies where they are enrolled in government subsidised training, including Smart and Skilled, or they are discontinuing their studies.
• Deferring your studies – government subsidised training, including Smart and Skilled
You have decided to defer your studies, and have identified your proposed return to study within a period up to 12 months (including previous
periods for the same qualification) from date of lodgement of your withdrawal/deferment advice. The Student fee or Concession fee will
remain as identified when you enrolled, and will not change during the period of deferring your studies. Any unit/s attempted/not completed
within your enrolled qualification will record a withdrawn (WN) result, and the student fee or fee exemption covers this first attempt at these
unit/s. When you return to study after your deferment, you will need to pay an additional fee for the second attempt at these Unit/s.
• Discontinuing your studies
You have decided to cease studies in your enrolled qualification, or have not returned to study within 12 months of deferring of your studies.
If you wish to return to complete this qualification, you will be re-assessed against the Smart & Skilled/government subsidised training
eligibility and entitlement criteria, current at that time, to determine your Student Fee or eligibility for a Concession fee or fee exemption.
• Discontinuing your studies and transferring to another Training Provider.
Note 1: When discontinuing your studies you will be provided with a Statement of Attainment Transcript
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 1: ‘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.
Note 2: Refunds are to be made to the student, organisation or third party who originally paid the relevant fee.
Note 3: There are no refunds for incidental fees
Note 4: Original payment via Credit Card and refund requested to that Credit Card requires evidence, such as credit card/bank statement required to
identify Credit Card details for refund purposes.
FEE AMENDMENTS – government subsidised training, including Smart and Skilled
Fee Amendments (including to future-dated fee instalments) are given in the following circumstances:
• You have paid the Student fee for the qualification but now receive Youth Allowance or Austudy commencing within two weeks of the Course Start
Date (you have an approval letter from Centrelink with a CRN and indicating your date of commencement of benefit – refer to Concession Fee
Application Form).
• You have been granted Credit Transfer for previous study for one or more Units of Competency, after the Course Start Date.
• You have been granted Recognition for Prior Learning (RPL) for one or more Units of Competency, after the Course Start Date. RPL should be discussed
with your class teacher and applied for at the commencement of classes/participation. (refer to Enrolment Adjustment - Recognition of Prior Learning
application form)
• You have paid the Apprenticeship Fee and then meet the Smart and Skilled eligibility for a Fee Free Apprenticeship on or after 1 July 2018.
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 the Department of Human
Services (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 7 October 2020

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