Student name
    Student ID
    Date [datetime datetime-619 id:r-date date-format:mm/dd/yy time-format:HH:mm]
    Course Enrolled In
    Email Address
    Contact No
    Address

    Please tick the applicable box to indicate your amendment type:

    DEFER EnrolmentSUSPEND EnrolmentCANCEL EnrolmentWITHDRAW Enrolment

    Please give a brief explanation of your reasons for amending your enrolment to support your application:

    I am aware of the consequences of deferring, suspending, cancelling or withdrawing my enrolment.
    I am also aware that the decision to grant my deferral, suspension, or cancellation of enrolment may affect my student visa (international students only).

    Student name
    Student Sign
    Date[datetime datetime-533 id:rr-cf-sdate date-format:mm/dd/yy time-format:HH:mm]