Withdrawal Application

Student Information

Student ID

Given Name

Last Name

Gender

Male
Female

Date Of Birth

Mobile No.:

Email Address

Enrollment & Withdrawal Details

Qualification Code

Qualification Title

Fees Paid

Fee Payer Name

Address

Select one of the following options

Withdrawal from course
Withdrawal from units of study on or before census date (no debt incurred or refund given if payment has been made)
Withdrawal from units of study after census date (no refund given/debt still incurred unless special circumstances apply)

Reason for Withdrawal

Refund Details

Refunds are payable to the Fee Payer nominated above. Where payments have been made by credit card, refunds can only be issued to the original credit card number. For electronic transfer of funds, please complete details below:

Units of Competency (For Withdrawal)

Unit Code

Unit Title

* In order to verify that you are the person submitting application form, please take a photo of yourself

Account Name

Bank Name

Branch

BSB Number

Account Number

I hereby acknowledge that I have been provided with details of the Vibe College’s Fee and Refund Policy and the information provided in this form is true and correct. *

I understand that if my course has already commenced, I will be provided with refund based on the refund policy stated within offer letter at the time of my enrollment. *

Learner Name

Image Upload *

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Signature

Date

Captcha *

Message