Praxis Notice of Withdrawal/Transfer

To: Student Management	Today’s Date:

From:	Course:

(Course Coordinator)

Name of Student:	ID Number:___________________

Is the student withdrawing completely from the programme?	Yes No

IF NO, PLEASE STOP HERE AND COMPLETE PAGE TWO (REVERSE OF THIS PAGE)

IF YES, DO WE KEEP THE EFTS VALUE? Yes No

Date Programme Started:

Date Student Withdrew:

Tuition Fee Refund - choose one level only:

LEVEL 1	w/d up to 8 days = 100% less administration costs of up to 10% of any amount paid or $500, whichever is the lesser - w/d fee	Is this date within the 8-day period? Yes
LEVEL 2	w/d within 2 - 4 weeks = 80%	Is this date within the 2 – 4-week period? Yes
LEVEL 3	w/d after 4 weeks = no refund	Is this date after the cut off period? Yes

If Level 1 STOP HERE, Levels 2 & 3 complete refund instructions

Is this student eligible for a refund of the:

Tuition Fee?	No Yes	How Much?

Programme Fee?	No Yes	How Much?

NZQA Credits Fees?	No Yes	How Much?

Enrolment Administration Fee?	No Yes	How Much?

(The appropriate w/d fee will be deducted from this total)

TOTAL

Withdrawal after the cut off date.

Are there special circumstances leading to a full refund of fees? Yes

Course Coordinator Signature

Signed	Head of School

FINANCIAL SERVICES USE ONLY Refund to Studylink	Actioned by ……………………… / /

STUDENT MANAGMENT USE ONLY Withdrawal actioned by …………………………………………….. / / Refund …………………………………... / /01

Transfer Within A Programme (A) OR Partial Withdrawal From A Programme (B)

Date of Change

COMPLETE EITHER SECTION A OR B

SECTION A

Transfers within a programme only (transfer to another programme requires Page 1 withdrawal details completed and re-enrolment in the new programme)

Modules/Courses transferred from:	Modules/Courses transferred to:

SECTION B

Partial withdrawal from a programme only (complete withdrawal requires Page 1 withdrawal details completed)

Modules withdrawn from:

Withdrawals only:

DO WE KEEP THE EFT VALUE? Yes No

Is this student eligible for a refund of the following fees for the individual modules they have withdrawn from?

Tuition Fee?	No Yes	How Much?

Programme Fee?	No Yes	How Much?

NZQA Credits Fees?	No Yes	How Much?

TOTAL

Signed:	Student

Signed:	Course Coordinator

STUDENTS:

PLEASE COMPLETE THIS PAGE ONLY IF WITHDRAWING FROM THE WHOLE PROGRAMME

Praxis is genuinely interested in your reasons for withdrawing from a Programme or Course - we might be able to offer assistance. To be effective, we need to be informed so that we can respond to your needs.

Please note: Withdrawal from a programme may mean that you will not be eligible to receive a Student Allowance in future years..

Could you please assist by answering the following either by ticking the appropriate box (ONE BOX ONLY PLEASE) and adding comments if necessary.

COMMENTS ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… Personal Reasons.

Personal health

Family health

Personal crisis

Family commitments

Accommodation problems

Relocated to another area

Cultural/religious reasons

Simply did not wish to continue

Non-achievement

Deceased

Financial Reasons.

Student Allowance/Student Loan difficulties

Transport costs too high

Accommodation costs too high

Unable to live on student income

Non-attendance.

4.	To Employment.

To apprenticeship/traineeship

To full-time employment

To part-time employment

5.	Programme dissatisfaction.

Unhappy with tutoring/delivery

Students expectations not met

Lack of support/resources

Cultural/religious reasons

Transferred.

Transferred to another program

Transferred to another institute

7.	Cancellation.

Cancellation of programme

Cancellation of enrolment

8.	Not stated.

Signed: _____________________________________________ Student