Extenuating Circumstances
Application Form
Extenuating Circumstances Application Form
Extenuating Circumstances takes into account serious events beyond your control that occurred after the first 7 days of your
course start date affecting your ability to continue with your studies.
These can include any of the following:
• Medical circumstances that became known or changed after the first 7 days of your course start date and prevented you
from completing your studies
• Family or personal reasons, such as death or severe medical problems or unforeseen financial difficulties, which made it
impossible for you to continue your studies
• Other extenuating circumstances
Extenuating Circumstances does not include:
• Changing your work hours;
• Changing your job;
• Relocating or changing address;
• Changing your mind regarding the course or the reasons you are undertaking the course;
• Other employment circumstances such as redundancy, resignation or termination. * except where it can be demonstrated
that this situation has led to considerable family/personal circumstances (i.e. severe financial hardship or a significant
medical condition).
Where Extenuating Circumstances is granted, Open Training Institute may agree to:
• Extend the time allowed for course completion;
• Waive future payment instalments; and/or
• A pro rata refund of course costs based on portion of the course already undertaken or accessed. *Please note, depending on
status of current payments, students may be left with an outstanding amount or be required to continue payments up to the
date of their circumstances occurring.
Application Period.
All Extenuating Circumstances applications must reach Open Training Institute within 12 months from the date of your
circumstances occurring.
Extenuating Circumstances Applications
Extenuating circumstances may only be considered where they:
• Are beyond your control
• Are sufficient to prevent you from completing your study successfully, and
• Could not have been anticipated at enrolment or within 7 days of your enrolment date
If you are applying for an Extenuating Circumstances Refund you will be asked to provide evidence of your circumstances.
Section C includes a list of evidence that is needed. Please tick the box/es to indicate the evidence you are providing and attach
it to your application.
Page 2/5
Extenuating Circumstances Application Form
For Medical Reasons
A statement from a doctor or other health care professional registered with a professional body or association stating:
1. The date your medical condition began, changed or became worse, and
2. How your condition affected your ability to study, and
3. When it became apparent you could not continue your study.
You must be able to demonstrate that the circumstances were not foreseeable prior to the date of your enrolment.
For Family/Personal Reasons
For Family/Personal Reasons: A statement from a doctor or other health care professional registered with a professional body
or association stating:
1. The date your family/personal circumstances began, changed or became worse, and
2. How your circumstances affected your ability to study, and
3. When it became apparent you could not continue your study.
If requesting Special Circumstances due to the death of afamily member or close friend, you are required to supply
documentation to substantiate your relationship to the deceased (e.g. from a doctor or other health care professional).
You must be able to demonstrate that the circumstances were not foreseeable prior to the date of your enrolment.
For Financial Hardship Reasons
You are required to supply a dated and signed statement from a financial counsellor. This should include:
1. The date your financial circumstances began, changed or became worse, and
2. H
ow the your circumstances affected your ability to study, and
3. When it became apparent you could not continue your study.
IMPORTANT INFORMATION:
You will need to inform the person providing your supporting documentation that the statement will be sent to Open Training
Institute in support of your application and it should include information to that effect. Please ensure that all letters are dated,
are on letterhead & contains all relevant authorisation details of the person providing the statement.
Page 3/5
Extenuating Circumstances Application Form
1. Personal and contact details
Student Number:
Title:
Mr
Mrs
Miss
Ms
Dr
Surname:
Other
First name:
Street address:
Suburb:
Home phone:
Postcode:
State:
Mobile phone:
Email address:
2. Enrolment details
Qualification:
Completed:
Module 1
Module 2
Module 3
Module 4
Payments:
Payment plan
Upfront (full)
Employer
Other
3. Extenuating Circumstances Refund
Please tick the criteria that you meet for a Extenuating Circumstances Refund:
Medical reasons
Family/personal reasons
Financial hardship
Please let us know:
The date your circumstances changed/became worse:
How your circumstances have affected your study:
When you realised you could not continue study:
Which evidence have you attached to this application?
Medical certificate/letter
Counselling letter
Other
Page 4/5
Extenuating Circumstances Application Form
4. Declaration
I am aware of financial consequences of the above request and have sought appropriate advice on these matters.
I declare that the information I have given on this application is correct and understand that by knowingly making
false or misleading statements I may be liable for prosecution.
SignatureDate
Please forward this form with supporting documentation to:
Mail: Open Training Institute, GPO 5387, Melbourne VIC 3001
Email: [email protected]
Next Steps:
Upon receipt of your application, Open Training Institute will send you an acknowledgement via email. If you have not
received an acknowledgement of your application within 5 business days of submitting it, please contact the Student
Equity team on the below email address.
If you have any enquiries, please email the Student Equity team at [email protected]
Disclaimer:
The decision to approve or not approve a refund will be considered principally on thebasis of your independent
supporting documentation. It is your responsibility to ensure all relevant documentation is provided with your application.
On occasions, Open Training Institute may request further independent documentation be supplied if it is deemed that
the documentation provided is not sufficient to make an informed decision on your application.
You will be advised by email of the decision made. If you are not satisfied with the decision, you may request a review
from the Open Training Institute Review Officer.
Open Training Institute collects, stores and uses personal information for the purposes of enrolling a student in a course
of study and managing participation in that course.
The information collected is confidential and will not be disclosed to third parties without your consent.
Page 5/5