Postgraduate Study Support
Scheme: Application Form for
Renewal of Financial Support
TO BE COMPLETED BY APPLICANT
I hereby apply for a 25% rebate of the fees for a postgraduate course or Associate Student Program
subject(s) for the coming academic session. I understand that I am bound by the current Academic
Regulations of Charles Sturt University.
Staff member’s details
1.
Applicant’s name:
2.
Position:
3.
4.
Division/Section or
Faculty/School:
CSU campus or site:
5.
Contact telephone number:
6.
E-mail address:
7.
Staff number:
Session details
8.
11.
Name of postgraduate
course or Associate Student
Program subject(s):
Number of subjects (or
thesis) in the coming
academic session:
Total course fees for the
session:
Start date of session:
12.
End date of session:
9.
10.
subjects
thesis
$
Applicant’s signature:
Date:
Managers signature:
Date:
Endorsement: Manager, Learning and Development, Division of Human
Resources:
Signature:
Date:
.
Postgraduate Study Support Scheme: Application for Renewal of Financial Support (PG2)
October 2011
Page 1
Postgraduate Study Support Scheme
Application for Renewal of Financial Support
(Applicants’ Checklist)
Complete the “Application for Renewal of Financial Support Form” (PG2).
Submit the application form directly to the Career Programs Officer,
Division of Human Resources, Wagga Wagga.
Privacy Statement
The personal information you provide on this form is protected by the Privacy and Personal Information
Protection Act 1998 (NSW).
Provision of this information is a requirement of participation in CSU’s Postgraduate Study Support
Scheme for General Staff.
Access to the information you provide is available to yourself, your supervisor, the Executive Director /
Dean / primary budget centre manager, and those persons authorised to access the information in the
course of their duties to CSU.
This document will be stored in the Organisational and People Capability Directorate, Division of Human
Resources.
Postgraduate Study Support Scheme: Application for Renewal of Financial Support (PG2)
October 2011
Page 2
Staff Development – Fee Support
If you wish to repay your CSU loan instalments by direct debit from
your salary, please sign and complete and this form.
To:
Accounts Receivable
Division of Financial Services
WAGGA WAGGA
Name:
(Please Print)
CSU Salary Number:
I authorise Charles Sturt University to deduct the sum of
$__________ per fortnight from my salary, for _________
commencing on
/
/
* fortnights,
until my debt of $__________ is repaid
in full.
Signature:
__________________________________________
Date:
/
Tertiary Institution:
__________________________________________
*
/
When calculating the number of fortnights, the final dates for payment will be the
last day of the relative session or trimester to which the fees relate.
NOTES:
1.
2.
3.
In the event of termination of employment with Charles Sturt University, the
amount outstanding will be deducted from your termination pay.
In the event of termination of study, any refund should be applied to any
outstanding debt with Charles Sturt University.
If you are studying at an institution other than Charles Sturt University, a cheque
will be drawn in favour of that institution and sent to you. It will be your
responsibility to forward the cheque and any associated paperwork to that
institution for processing.
To commence this process, please return this form to Accounts Receivable in
Wagga Wagga, along with a copy of your liability statement.