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

Within Australia:



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.

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Authorisation 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