Course Extension for Extenuating Circumstances – Student Application Form 1COURSE EXTENSION PERIOD2STUDENT DETAILS3DECLARATION & PAYMENT Students at I.T.S or using the I.T.S portal seeking a course extension due to extenuating circumstances must complete and submit this application form. Along with the form, students are required to provide evidence of the hardship at the time of submission. Please note: Course extension requests should be submitted as early as possible, and no later than 48 hours before the original course end date. To view our Course Extension Policy, visit: https://www.its.vic.edu.au/knowledge-base/course-extension-policy/ PLEASE SELECT THE COURSE EXTENSION PERIODPlease select the Extension Period(Required) One Month (Minimum) Two Months Three Months (Maximum per Application) Students requesting a course extension due to extenuating circumstances may apply for a maximum extension of three months at a time, with a total limit of six months for all extensions combined. STUDENT DETAILSI.T.S Student NumberExample: ITS000123X (10 characters) or AITS200001X (11 characters) - Your student number must start with 'ITS' or 'AITS' and contain the correct amount of charactersName(Required) First Last Date of Birth(Required) Day Month Year Mobile Phone Number(Required)Email Address(Required) Enter Email Confirm Email COURSE DETAILSCourse Name(Required) TLI41222 Certificate IV in Motor Vehicle Driver Training (Car) TLI41222 Certificate IV in Motor Vehicle Driver Training (Heavy Vehicle) TLI41222 Certificate IV in Motor Vehicle Driver Training (Motorcycle) TLISS00162 Driving Instructor Skill Set TAESS00021 Facilitation Skill Set Other If Other: Enter Course Name(Required)Course CodeYear First Enrolled(Required) Evidence of Extenuating CircumstancesTo apply for a course extension due to extenuating circumstances, you must provide one of the following forms of evidence: Possible Evidence for Extenuating Circumstances: Medical Certificate: A signed and dated document from a licensed healthcare professional detailing a medical condition that has impacted your ability to complete the course on time. Mental Health Documentation: A letter or report from a qualified mental health professional indicating a significant mental health issue affecting your studies. Bereavement: A death certificate or obituary notice confirming the passing of an immediate family member or close relative. Court Summons or Legal Documentation: Official documents demonstrating your involvement in legal proceedings that have affected your course progress. Natural Disaster or Emergency: Official reports or statements confirming your displacement or impact due to a natural disaster or other emergency. Employment-Related Hardship: A letter from your employer outlining unexpected changes in work hours or job loss that directly impacts your ability to study. Family or Caregiving Responsibilities: Documentation, such as a letter from a social worker or relevant authority, verifying significant and unforeseen caregiving responsibilities. Financial Hardship: Evidence of sudden and severe financial difficulties, such as a letter from a financial advisor or bank statement showing a significant loss of income. Other Relevant Documentation: Any other official documents that clearly support your claim of extenuating circumstances impacting your ability to complete the course on time. Upload your evidence here:(Required) Drop files here or Select files Max. file size: 64 MB, Max. files: 5. STUDENT DECLARATIONStudent Declaration(Required) I declare and acknowledge the following in relation to my request for a course extension:Understanding of Extension Start Date: I understand that any course extension granted will commence from the original end date of my course, without exception. Impact of Delay in Application: I acknowledge that if I delay in applying for a course extension, and my application is submitted within 30 days of my course's scheduled end date, the duration of my course extension may be reduced accordingly. Consequence of Late Application: I am aware that if my application for a course extension is submitted after my course's scheduled end date (30-days after), my course will be finalised, and my request for an extension may be denied. Responsibility for Timely Application: I accept that it is my responsibility to apply for a course extension in a timely manner, considering the stipulated time frames outlined by Intelligent Training Solutions. Acknowledgment of Policy Terms: I have read, understood, and agree to adhere to the terms and conditions set out in the Student Course Extension Policy of Intelligent Training Solutions, and that the information in the policy is available to me at the top of this form. Accuracy of Information: I confirm that the information provided in my course extension application is true and accurate to the best of my knowledge. By signing below, I acknowledge and agree to the above terms related to my course extension request. Signature(Required)PAYMENT METHODPREFERRED PAYMENT METHOD(Required) Credit Card (Stripe) PayPal NO ADDITIONAL FEES APPLYTotal