Application for Leave/Deferment/Suspension
Leave Type: (please tick appropriate box)
Please specify the date in which you request to begin and conclude leave
Please provide the following in support of your leave request
Are you travelling outside Australia?
Person of Contact
I hereby understand that as part of the Letter of Offer and Student Agreement, Refund Policy, that it is solely my responsibility to maintain course progress and uphold my Payment Plan payments whilst on leave.
I understand that this suspension or deferment or leave of absence will be reported via PRISMS and may affect my student visa.
Office Use OnlyAuthorisation by the Program Director
I hereby authorise for _________________________________________(name) to ____________days leave/deferment.
Program Director Signature Date
Authorisation by the Program Director
President’s Signature Date