Request for internal review

Review for Remission/Refund of debt in special circumstances outcome

Required fields are marked with an asterisk (*).

Your details

Student ID number *

Family name *

Given name *

Email address *

Street number and name

Suburb

State

Country (leave blank if Australia)

Postcode

Phone number We may need to contact you for further information. Please provide a current phone number.

Application details

Course * This is the course you are studying, not the individual units.

The study period of your application

When did you receive your Remission/Refund of debt in special circumstances outcome notification? *

Day Month Year

If this date is more than 28 days ago, please explain why you did not submit your review within the allowed time limit

Review details

Your outcome letter will detail the reasons why your application was unsuccessful and what Remission/Refund of debt criteria your application did not meet. To have your review assessed you must address each of these criteria using the options below. Choose only the criteria detailed in your outcome letter, provide an written reason why you believe you meet the criteria and upload supporting documents. PDFs, PNG, JPG or TIFF files accepted. Combine all documents for each criteria, into one file before uploading. Use this opportunity to address the eligibility criteria and reasons listed and not as an opportunity to criticise the assessor. Please be reminded of the Student Code of Conduct requirement to communicate with courtesy and consideration. The Student Code of Conduct may be viewed in the Deakin Policy Library.

Reason one

Why was your original application unsuccessful? *

Please explain why you believe you meet this criteria. Please address the reasons provided in your outcome letter.

Provide documents not previously submitted to support your statement/s above. *

Reason two

Why was your original application unsuccessful?

Please explain why you believe you meet this criteria. Please address the reasons provided in your outcome letter.

Provide documents not previously submitted to support your statement/s above.

Reason three

Why was your original application unsuccessful?

Please explain why you believe you meet this criteria. Please address the reasons provided in your outcome letter.

Provide documents not previously submitted to support your statement/s above.

Reason four

Why was your original application unsuccessful?

Please explain why you believe you meet this criteria. Please address the reasons provided in your outcome letter.

Provide documents not previously submitted to support your statement/s above.

Further information

If you have any additional information please provide below:

Further document

Declaration

I agree to the following *

I declare that the information provided by me is true and complete.
I acknowledge
- it is my responsibility to establish sufficient grounds for this application and to provide evidence to demonstrate that these grounds exist.
- it is my responsibility to provide independent supporting documentation to confirm the dates and events in my application and that these documents are genuine and I understand Deakin University is not responsible for obtaining documentation on my behalf.
- Deakin University will not ask me to provide further documents and that my Request for internal review will be assessed on the information I provide with this form.
- Deakin University reserves the right to verify the information provided and may review, vary or reverse any decision on the basis of incorrect or incomplete information provided.
- I may be subject to disciplinary action by Deakin University if the information I provide is false, altered or misleading.
I consent
- to Deakin University contacting any person named in my application, including Faculty staff, Deakin Resource Centre, Deakin Counselling and external persons/organisations, including medical practitioners and employers, to verify or clarify the information provided.
- to the University accessing information I may have previously submitted for applications to the University for Special Consideration, assignment extensions or other process, which may be relevant to this application.
- to any person or organisation contacted, to provide Deakin University with information relevant to my Remission of debt in special circumstances application and that this form, signed by me be can be used by Deakin University as evidence of my consent.
I understand
- I may be asked to provide more specific consent for disclosure of information should this be required.
- this information will be retained by and subject to Deakin University’s Privacy policy.

Deakin University is collecting your personal information on this form for the primary purpose of assessing and processing your application and to comply with Government and other reporting requirements. The University will verify the information provided by you, including confirming details with third parties mentioned by you and to carry out associated investigations connected with your application.

For these purposes Deakin may also provide this information to Commonwealth and State agencies such as the Department of Education, Skills and Employment and the Department of Home Affairs in accordance with Deakin’s obligations under the Education Services for Overseas Students Act 2000 (Cth) (ESOS Act), the National Code of Practice for Providers of Education and Training to Overseas Students 2018 (National Code) and other applicable legislation.

Deakin manages personal information it holds, including requests by individuals for access to their personal information, in accordance with the Privacy and Data Protection Act 2014 (Vic). Deakin’s Privacy Policy may be viewed in the Deakin Policy Library.

Information on privacy at Deakin is available at deakin.edu.au/privacy. Questions about privacy may be directed to the Privacy Officer on (03) 5227 8524 or by email to privacy@deakin.edu.au.

Contact Student Central if you have any queries or if you cannot complete this form.