Media
Design
School
Student
Initiated
Transfer/Withdrawal
Form
DOMESTIC STUDENT INTERNATIONAL STUDENT
SECTION 1- STUDENT DETAILS
FULL NAME:
STUDENT ID NUMBER:
QUALIFICATION:
COURSE START DATE:
CONTACT DETAILS:
RESIDENTIAL ADDRESS:
MOBILE:
EMAIL:
MDS supports the right of students to withdraw from a programme of study. Students are required to follow the procedure for withdrawal.
MDS has specific rules regarding when a refund will be granted and the amount that will be paid, which are related to the reasons for, and
the timing of, a student’s withdrawal request. Please refer to the Withdrawal and Refund Policy
SECTION 2 - SELECT SITUATION
1.
WITHDRAWAL - Due to a change of personal circumstances, e.g. relocation to a different city or country. The student’s enrollment is cancelled.
2.
TRANSFER TO NEW QUALIFICATION - Withdrawal from current enrolment and reapply for admission to a different qualification in the next
intake
3.
RESTART TRANSFER - W ithdrawal from current enrolment and reapply for admission to restart the same qualification in the next intake
4.
TRANSFER TO FIRST CHOICE ENROLMENT - Current enrolment is not first choice due to MDS not offering the qualification initially
enrolled in at the previous intake. Withdraw from current enrolment and transfer to next available intake for first qualification choice
5.
LEAVE OF ABSENCE – A temporary break from a student’s programme of studies, usually for personal reasons, e.g. to get married; take an
extended holiday; or care for a dependent for a short period of time. Assessed on a case-by-case basis. Depending on the duration, the student's
enrolment may be cancelled.
6.
COMPASSIONATE TRANSFER - Leave programme at the time at which exceptional circumstances arose and transfer to the next intake
to
complete unfinished c omponent
SECTION 4 – SUPPORTING EVIDENCE (Select all that apply)
1.
STUDENT REQUEST LETTER (this is a mandatory requirement)
2.
MEDICAL CERTIFICATE
3.
ENDORSEMENT FROM OTHER HEALTH PROFESSIONAL
4.
DEATH NOTICE
5.
OTHER – PLEASE SPECIFY
Media Design School
10 Madden Street
Wynyard Quarter
Central Auckland 1010
+64 9 303 0402
mediadesignschool.com
SECTION 3 – REASON for the selected situation
Academic Reason
Change of course
Financial hardship
Medical condition
Mental health
Take a break
Moving out of New Zealand
Personal reasons
Fa
mily related
Visa related
Work full-time
Other (provide details below)
SECTION 5 - STUDENT DECLARATION: SELECT ALL THAT APPLY
I acknowledge that I have read and understand that I am liable for all fees as invoiced, unless I withdraw by the end of the eighth calendar day
(Domestic Students) or tenth working day (International Students) of the commencement date of the programme. In these cases I am entitled to
receive a full refund less a deduction for costs incurred by Media Design School (MDS) as per the MDS Withdrawal and Refund Policy
I acknow
ledge that MDS needs to be in receipt of all payments, library books & resources belonging to the school, and that failure to return any
such items will result in these being invoiced on a cost recovery plus 30% basis
I understa
nd that MDS is obliged to notify Studylink (if a Domestic student) and that I will no longer be eligible for any
student allowance I may have been receiving in relation to this course if applicable.
I understand that MDS is obliged to notify Immigration New Zealand (if an International Student) and that my visa related to this
course will be cancelled if applicable
In cases of withdrawal and de-registration (if an International student) my Health and Travel Insurance Policy provider will be notified. The
policy will be cancelled. If your intention is to stay in New Zealand you will need to make the necessary arrangements for your insurance.
I underst
and that the information I provided will be stored, used and shared according to the MDS Privacy Policy. I also understand that MDS
may contact me with information relating to my request.
Student Signa
ture Date _______________
OFFICE USE
Programme Leader:
Date ______________
Associate Dean: Date ________________
Registrar:
Date ______________
Start
Are you applying for
a transfer under
circumstances that
are beyond your
control?
NO
Have you made
a decision to
change the
qualification in
which you are
enrolled?
Have you failed more
than half of your
courses for the
current year and wish
to restart your
qualification?
Please discuss your
situation with your
Programme Director.
You may be eligible
to resit some of the
courses.
NO
NO
Restart Transfer
If approved, you must withdraw and
reapply for admission to the same
programme in the next intake. Please
check that you have passed suicient
EFTS to be eligible for a Studylink
student loan/allowance.
YES
Transfer to New
Qualification
If approved, you
may be withdrawn
from your current
enrolment and
reapply for
admission to a
dierent programme
in the next intake.
Has your academic progress
been significantly hindered by
a personal injury, medical
condition, bereavement or
other personal issues beyond
your control?
NOTE: Medical circumstances
require presentation of
medical documents.
YES
NO
You may apply for a
Compassionate Transfer
If approved, you may be
able to leave your
programme at the time the
exceptional circumstances
arose and transfer to the
next intake at the point at
which you left to complete
any unfinished
components.
YES
Is your application to
transfer a direct result of
MDS programme oering
decisions (i.e. due to the
qualification in which you
were initially enrolled not
being oered in the
previous intake, you are
seeking to transfer from
your current programme
back to your first
qualification)?
Transfer to First Choice
Enrolment
You may be able to
withdraw from your
current programme and
transfer to the next intake
available for your first
qualification choice as per
conditions in your
agreement with Media
Design School.
Please discuss your
situation with the Student
Counsellor or Māori &
Pasifika Success Coach.
YES
YES
NO
Guide to Transfer Types