eWC Withdrawal Request Form

endota Wellness College Pty Ltd

RTO 88123

ABN 21 104 897 743

ACN 104 897 743

Students wishing to transfer studies to another Registered Training Organisation should also complete this form.

Students seeking a remission of a VETSL debt because of special circumstances may apply using eWC's Special Circumstances Application form.

First Name: *

Last name: *

Street Address: *

Suburb/City: *

State: *

Postcode: *

Phone Number: *

Email: *

Course: *

Course Start Date: * +

I am accessing (select all that apply): *

VET Student Loans

State Funding

Neither

I wish to (please tick the most appropriate box): *

Withdraw from my course

Withdraw from Unit/s of Study only

Transfer my course to another provider

Reason for course withdrawal: *

If Other, please specify: *

Which Unit/s of Study do you wish to withdraw from? *

Reason for Unit/s of Study withdrawal: *

Have you completed any written tasks or practical observations that require assessment? Please note: Assessment marking may take up to 5 business days to be completed by your trainer/s. *

No

Yes - The date of your withdrawal may be adjusted to reflect any assessments that may occur after submitting this form.

Please upload supporting evidence here:

Supporting evidence attached? *

Yes

No

Further comments (if applicable):

Student Declaration
I declare that the information I have supplied is correct and complete and that the supporting evidence (if applicable) is authentic. I have read eWC’s Discontinuing Student and Refund Policy and understand I am liable for any outstanding fees relating to study periods commenced prior to withdrawing if the census or due date for that period has occurred, unless my application for special circumstances has been approved (VET Student Loan debts only). *

Yes I agree

Student Signature: *

clear

Date: * +