Student Forms

Form Selection
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Form Fees
Form Fee: AUD
* I understand that the fee is non refundable and it is a processing fee for my application
Conditions of Special Leave
Special leave can be granted for a maximum 4 weeks in limited circumstances only. Special leave can be requested only once per course. Students requesting special leave must:
- Provide evidence of compassionate of compelling circumstances such a certified medical certificate, evidence of trauma or emergency
- Provide flight tickets if leaving Australia
- Have satisfactory academic progress as required under student visa conditions
- Be able to complete their course work satisfactorily within the current study term
NOTE: It is your responsibility to complete assessments during the period of leave
How do I apply for Special Leave?
To apply for special leave, complete this form, attach evidence supporting your request, and submit online. You may need to speak to your trainer or the Academic Manager to discuss maintaining course progress. When is the leave granted? You will be notified of the outcome in writing via email as soon as we can.
Please contact Reception if you require more information.
Student Details
Student Number*
Student Last Name*
Student Given Names*
Student Full Name*
Email Address
Email Address*
Contact Phone Number*
Current Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Instalment you wish to receive payment plan for*
Please choose how you want your instalment to be split / postponed*
- Fee to be split in 2 instalments (half on due date, half two weeks later)
- Fee to be split in 3 instalments
- Individual plan (you will be required to provide evidence such as letter from the employer about losing a job or a bank statement etc.)
Please explain why do you want to apply for a payment plan*
I understand that:*
- Intention to report may be issued automatically 3 days after instalment due date. If your pay plan has been approved the fees and charges of the payplan apply. If the fees are not paid exactly as per your payplan the ITR conditions and late fees apply.
I understand that:*
- It is NOT possible to apply for a payplan after the instalment due date
Signature of Student

(Required to be submitted before Term / Mid Term Start Date)
Current Campus
Current Campus
Change To New Campus
Change To New Campus
Explain why you want to change your campus:
Please read and tick:
- I acknowledge that Campus change fee of $100 is payable immediately on approval.
- acknowledge that changing from a campus does not release me from any financial commitments I have previously agreed upon
- I acknowledge that failure to pay my outstanding fees may lead to academic failure.
- I acknowledge that I may not be permitted to a campus change in some circumstances.
- I acknowledge that it is my responsibility to contact the College to determine my financial liabilities and any academic issues.
Signature of Student

(Required to be submitted before Term / Mid Term Start Date)
Change of course requests will be approved (or not) by the Academic Manager (or delegate) based on your current Academic Progress and the entry requirements of the course you are requesting to change to. If you have poor academic progress or do not meet the entry requirements of the future course your request will not be approved.
Enrolment Details
Current Class
Current Class
Session Time
Change To
New Class
New Class
Session Time
Explain why you want to change your course:
Please read and tick:
- I acknowledge that COE change fee of $200 is payable immediately on approval.
- acknowledge that changing from a course does not release me from any financial commitments I have previously agreed upon
- I acknowledge that failure to pay my outstanding fees may lead to academic failure.
- I acknowledge that I may not be permitted to a course change in some circumstances.
- I acknowledge that it is my responsibility to contact the College to determine my financial liabilities and any academic issues.
Signature of Student

DEFERMENT OF STUDIES:
- Any international student requesting deferment of their studies should be aware that the Department of Immigration and Border Protection (DIBP) will only permit City Institute to allow a student to defer their studies in very limited circumstances i.e. for major illness, accident or other exceptional compassionate circumstances beyond the control of the student e.g. death in the family.
- If a student defers their studies on any other grounds, the College must report the student as not complying with visa conditions to Department of Immigration and Border Protection.
- Deferring, suspending or cancelling your enrolment may affect your student visa. In this event, City Institute must notify the Department of Education via PRISMS as required under section 19 of the ESOS Act
- Weddings, cultural and religious activities generally are not acceptable reasons for deferment of studies.
- Students must apply for deferment of studies in writing (using this Form) and submit supporting documentation (e.g. medical certificate from a registered medical practitioner, death certificate, return air tickets) to Student Services. Any documents of a personal nature should be enclosed in an envelope and labeled CONFIDENTIAL.
- Deferment of studies will not be permitted unless all documentation is sighted first.
- If deferment of studies is granted, it will not be granted for any duration less than 2 weeks.
- Should it become necessary for a student to cancel part or all of the leave, they should notify the College in person or in writing.
- Tuition fees have to be settled before students defer their studies if the next payment date occurs during the leave period. No student will be granted an extension in the time before their next installment of fees falls due, on account of a deferment of studies.
Enrolment Details
Current Course
Current Course
Trainer & Session Time
DEFERMENT / SUSPENSION PERIOD REQUESTED
From
Till
Please state the reason for requesting a deferment of studies. (If you need more room, attach a separate page)
EVIDENCE
Attach supporting evidence to justify a deferment of studies*
Drop files here or
Is supporting evidence attached to justify a deferment of studies?
- Yes
- No
(if ‘No’, application will be rejected)
DECLARATION
- I understand that change of eCOE attracts $200 fee and is payable at the time of applying.
- I declare that the details provided by me are correct and complete.
Signature of Student

(Required to be submitted before Term / Mid Term Start Date)
Enrolment Details
Current Class
Session Time
Change To
New Class
Session Time
Explain why you want to change your class session
Please read and tick
- I acknowledge that a fee of $100 is payable immediately on approval.
- I acknowledge that I may not be permitted to change of class session in some circumstances.
- I acknowledge that a change a class session is applicable to once per course.
- I acknowledge that there is not guarantee of the trainer continuing for the entire duration the course
Signature of Student

Personal Details
Details of course/s you wish to cancel
Course(s) Name(s) Date you wish the COE to be cancelled
Course(s) Name(s) you wish to cancel*
Date you wish the COE to be cancelled*
Explanation*
- Withdrawal/cancellation - Students withdrawing/cancelling from Nortwest’s courses are required to do so well in advance, but no less than 4 weeks prior to the date that their fees are due or course/term start date (whichever comes first). Students must ensure that all outstanding fees are paid in full and understand that cancellation of enrolment does not remove the right of Nortwest to take further action under Australia’s Consumer Protection Law nor does it waiver financial liability. Overseas students must apply in writing and provide evidence to support the application. Fees may be payable for the application.
Are you leaving Australia?
- No
- Yes
If "Yes" provide your overseas address
Are you leaving Australia?*
- No
- Yes
If "Yes" provide your overseas address
Overseas Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact Phone Number
Personal Email*
Reason for Cancellation
Transfer to another provider
You must provide a copy of a valid letter of offer or a copy of the Confirmation of Enrolment (eCoE) of the new provider to which you wish to transfer. Nortwest has the right to refuse transfer to another provider if you have not completed six months study in your principal course and do not provide a legitimate reason for transferring to another institution. Applicants should consult Transfer between Registered Providers Policy on City Institute website for further information.
Name of new provider
Explanation
Attachments to support transfer to another provider
Drop files here or
Notification of cessation of studies
(I do not wish to continue with my enrolment and I understand that it will result in cancellation of my eCoE(s)).
Please provide further details
- I no longer hold a student visa (Please attach supporting documents, e.g. DIAC notification of change of visa status)
- I am permanently leaving Australia (Please attach supporting documents, e.g. Flight tickets, Doctor certificates)
- Other reason (Please give details below and attach supporting documents if applicable)
Please provide further details old*
- I no longer hold a student visa (Please attach supporting documents, e.g. DIAC notification of change of visa status)
- I am permanently leaving Australia (Please attach supporting documents, e.g. Flight tickets, Doctor certificates)
- Other reason (Please give details below and attach supporting documents if applicable)
Please provide further details old*
- I no longer hold a student visa (Please attach supporting documents, e.g. DIAC notification of change of visa status)
- Other reason (Please give details below and attach supporting documents if applicable)
Please provide further details*
- I no longer hold a student visa (Please attach supporting documents, e.g. DIAC notification of change of visa status)
- Other reason (Please give details below and attach supporting documents if applicable)
Explanation*
Explanation*
Supporting documents for cancellation*
Drop files here or
Refunds - Account Details
All refunds are made by Electronic Fund Transfer; please provide your bank details:
Bank
Account Name
BSB Number
Account Number
- I acknowledge that withdrawing/deferring from a course does not release me from any financial commitments I have previously agreed to and may lead to academic failure in certain circumstances.
- I acknowledge that it is my responsibility to contact the College to determine my financial liabilities and the Academic Manager regarding any academic issues.
Signature of Student

Card Type
- VISA
- MASTERCARD
- AMERICAN EXPRESS
Card Number
Card Holder Name
Expiry Date
Date Format: MM slash DD slash YYYY
CCV
Amount to be charged: $
Date of First Payment
Date Format: MM slash DD slash YYYY
Duration of Agreement
Date Format: MM slash DD slash YYYY
Signature

Conditions of Special Leave

Special leave can be granted for a maximum 4 weeks in limited circumstances only.
Special leave can be requested only once per course.
Students requesting special leave must:
- provide evidence of compassionate of compelling circumstances such a certified medical certificate, evidence of trauma or emergency
- provide flight tickets if leaving Australia
- have satisfactory academic progress as required under student visa conditions
- be able to complete their course work satisfactorily within the current study term
- NOTE: It is your responsibility to complete assessments during the period of leave
How do I apply for Special Leave?
To apply for special leave, complete this form, attach evidence supporting your request, and submit online. You may need to speak to your trainer or the Academic Manager to discuss maintaining course progress.
When is the leave granted?
You will be notified of the outcome in writing via email as soon as we can.
Please contact Reception if you require more information.
Enrolment Details
Current Course
Current Course*
Trainer & Session Time*
Units of Competency*
Special Leave Requested
From*
Date Format: MM slash DD slash YYYY
From
To*
Date Format: MM slash DD slash YYYY
To
Please state the reason for requesting a deferment of studies. (If you need more room, attach a separate page):*
Are you leaving Australia during your Special Leave?*
Attach flight tickets*
Attach Supporting Evidence for your Special Leave*
Drop files here or
Is supporting evidence attached to justify a Special Leave?*
- Yes
- No
(if 'No', application will be rejected)
*
- I declare that the details provided by me are correct and complete.
Signature of Student*

Student Date of Birth
Date Format: MM slash DD slash YYYY
Agent
This is a written agreement between the above mentioned student and City Institute.
Terms and Conditions
1. Only students applying for new a student’s visa or visa extension (onshore or offshore) are eligible for the $535 visa subsidy.
2. Student or an agent must provide a copy of the student's current visa stating the end date.
3. Student must provide a copy of paid application fee to DIBP as soon as practicable.
4. Student must apply for a combination of at least 18 months of courses to be eligible for the visa subsidy offer and remain a student for at least 18 months to be eligible for this promotion.
Cancellation and Refunds
1. Cancellation prior to 18 months of studies – a student who cancels, requests a change to their enrolment or remains unpaid at anytime within the first 6 terms of their contract will be deemed liable for the outstanding course fees, will be required to refund $535.00 and may be a subject of an additional cancellation fee.
2. A student with a cancelled visa will be a subject of City Institute’s Fees and Refund policy.
3. A student who lodges an invalid visa application, has their visa application rejected due to a lack of documents provided to Immigration department or has their visa cancelled due to not meeting their visa conditions will be disqualified from this offer and will be required to refund the $535.00 plus any other fees as per City Institute’s Fees and Refund policy.
Overdue fees
1. A student is required to pay their fees by the due date as agreed in Written Agreement. An overseas student who fails to pay their fees within five days from the agreed day will be reported to the Secretary of the Immigration department and the TPS Director via PRISMS.
2. Late payment of the tuition fees will apply as per the current Fees and Refunds Schedule.
3. A student with outstanding fees will not be permitted to attend classes until all outstanding fees have been paid in full.
- I have read and understand the terms and conditions stated above
- I have read and understand the cancellation conditions stated above
- I have read and understand that I have to provide a copy of the visa application fee to be eligible for the visa subsidy
- I am aware of the conditions that relate to my enrolment in course/s and agree to pay all fees for which I am liable
- I understand that if I decide to cancel my enrolment with City Institute prior to 12 months from my course start date I will be liable for outstanding course fees and cancellation fee as set above
- I understand that I cannot change my education provider during the first six months from my course commencement date without written permission from City Institute (International students only)
- I accept that if an Agent is acting on my behalf, I am responsible for meeting the above terms and conditions.
I have read fully and understand and accept the Terms and Conditions of this offer.
Signature of Student

USI Number
Date of Birth
Date Format: MM slash DD slash YYYY

Student Forms

Step 1 of 19

Form Selection

Conditions of Special Leave

How do I apply for Special Leave?

Please contact Reception if you require more information.

Student Details

(Required to be submitted before Term / Mid Term Start Date)

(Required to be submitted before Term / Mid Term Start Date)

Enrolment Details

Change To

DEFERMENT OF STUDIES:

Enrolment Details

DEFERMENT / SUSPENSION PERIOD REQUESTED

EVIDENCE

(Required to be submitted before Term / Mid Term Start Date)

Enrolment Details

Change To

Personal Details

Reason for Cancellation

Refunds - Account Details

Enrolment Details

Special Leave Requested

Terms and Conditions

Cancellation and Refunds

Overdue fees