International Student Request for Release

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Comments

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Perth College of Business and Technology Pty Ltd
RTO ID 52014

Student Number:*

Date:*

Family Name:*

Given Name:*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

Qualification*

Date from which you are seeking release

Reason as to why you are seeking release:*

Supporting documentation (tick all that apply)*

Explanation from student explaining reason or request

Offer letter from proposed new provider

Additional information (please describe)

Additional information (please describe):

File Upload

Accepted file types: pdf, doc, docx, jpg, jpeg, png, Max. file size: 256 MB.

Student Declaration:*

I have read and understand the Transfer of Provider Policy.

I have read and understand the Fees, Charges and Refund Policy

I understand that I will incur penalties and will have to clear all fees payable to date prior to a Letter of Release being provided.

I understand that I will receive a written response with ten (10) business days outlining the college decision.

Student Signature

Use cursor or mouse for sign.

Date:

Student has completed six months of principle course:

Student has satisfactory academic progress:

Assessing staff member:

Signature:

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Date:

Release Granted:

Date student informed:

PRISMS Variation Submitted:

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