Request for Enrolment Variation (Domestic)

> Request for Enrolment Variation (Domestic)

Request for enrolment variation (Domestic)

Title:*

Name:*

First

Last

Student ID:

Date of Birth:*

day

month

year

Current Course:

Email address:*

Confirm email address:*

Phone:*

Reason for enrolment variation - Please select one of the following options and answer it's corresponding question:*

1. Take a break from my course:

If you chose 'take a break from my course' please supply the start date and return date:

2. Change to another SRI course:

If you chose 'Change to another SRI course' please write what your new course is:

3: Have more time to finish my course:

If you selected 'have more time to finish my course' please select your new finish date:

Please outline the reason for your request:

If you have supporting documents please attatch them here:

Have you attached any supporting documents to this request?

Medical Certificate

Other

If you selected 'other' to supporting documents, please specify what documents you uploaded:

Student Declaration

Declare that the information I have supplied is true and correct
Have read the Sarina Russo Institute conditions of enrolment and refund policy: http://sri.edu.au/students/important-information/conditions-of-enrolment/
Understand that all units/courses already commenced must be paid for
Understand that payment for new units/courses must be made prior to course commencement

Signature of Agreement*

I agree to the Student Declaration

Full name:*

First

Last

Date*