HOLIDAY LEAVE APPLICATION FORM

This form should be used if you are intending to be absent from class for 5 -14 consecutive days or if you expect to miss the start of any trimester.

If you need to be absent for an extended period of time and are unable to maintain your course progression, you may need to defer your studies. In this instance, please complete the Student Course Deferment or Suspension Form (Continuing Students).

If an assessment is due in the period you will be absent, you should consider applying for Special Consideration by completing a Special Consideration Request Form. Special Consideration will be assessed in accordance with the Special Consideration guidelines in the Student Assessment Policy and
associated Procedure. Applications for Special Consideration must be received before the assessment event or within 3 days of the assessment event.

It will be your responsibility to contact your lecturer to discuss what you have missed in class.

Holiday leave during a Trimester will not usually be granted unless there are extenuating circumstances. You must provide a supporting evidence.

Please note that you will be notified of the outcome within 5 working days from the date of submission.

Please contact Student Services (studentservices@aih.nsw.edu.au) if you have any further queries regarding this application form.

PERSONAL DETAILS

Student ID: *

Title: *

Mr

Ms

Mrs

Other (please specify) Other (please specify)

First name(s): *

Family name: *

Sex: *

Male

Female

Date of birth (dd/mm/yyyy): * +

Phone (home/mobile): *

Email address: *

Full Address: *

City: *

State: *

Post code: *

Country: *

Course: *

HOLIDAY LEAVE DETAILS

Reason(s) for holiday leave (please tick): *

Medical

Going overseas

Other (please state below): Other (please state below):

I wish to take holiday leave from date (dd/mm/yyyy): * +

Returning from holiday leave date (dd/mm/yyyy): * +

Documents/Evidence upload:

Evidence Provided (if any, please state below): *

STUDENT DECLARATION

I declare that the information provided by me is accurate and complete. By signing this form, I declare that I understand the conditions stated on this form and as specified in the Student Progression and Exclusion Policy and associated Procedure.

Student's signature *

clear

Date: *

Privacy: We recommend that you read the AIH's Management of Personal Infomation Policy and associated Procedure published on our website [www.aih.nsw.edu.au]