Application for Withdrawal Application to Withdraw Application to Withdraw Please ensure to fill this form correctly. Incorrect or incomplete forms will result in delays or rejections. Student ID * Student Name Phone Email Course Name Address Student Withdrawal Request I (Print Name) Student Number I am enrolled at Melbourne Metro College and wish to apply to withdraw my studies in my course(s) stated below (List all courses you wish to withdraw from): I commenced my studies / was scheduled to commence my studies on and my last day of actual attendance is Student Reason for Withdrawal (Please detail your reason(s) for wishing to withdraw from your course(s) and attach any supporting documentation to support your request. Attach additional sheets if necessary) By signing this document, you are indicating that you are aware of Melbourne Metro College’s Student Deferment, Suspension and Cancellation Policy, Student Refund Policy and terms and conditions stipulated in your Offer Letter and Student Acceptance Agreement. I (Print Name) declare that all information and supporting documentation provided by me is true and correct. I understand that providing false information to Melbourne Metro College may result in termination of my enrolment and/or entitlements. Student signature Drop a file here or click to upload Choose File Maximum file size: 516MB Date Please note: If you are on a student visa and your cancellation request is approved, government legislation requires Melbourne Metro College to inform the Department of Home Affairs of the cancellation. This may affect your student visa. Office use only Student Services/Admissions Department Student Services/Admissions Department Signature Drop a file here or click to upload Choose File Maximum file size: 516MB Date Comments Accounts Department Tuition Fee Clear Yes No Admin Fees Clear Yes No Accounts Department Signature Drop a file here or click to upload Choose File Maximum file size: 516MB Date Comments Actions Taken By Actions Taken By Position Signature Drop a file here or click to upload Choose File Maximum file size: 516MB Date Application Approved Not Approved Comments Submit If you are human, leave this field blank.
