nLIVEn Pty Ltd
Program Variation - Information Sheet
Instructions
This form is to be used when applying for program leave,
program deferral or program discontinuation.
Please read the guidelines and advice below carefully:
 Complete all required details
 For Program Leave complete Section 3A
 For Program Deferral complete Section 3B
 For Program Discontinuation complete Section 3C
 Attach original supporting documentation as appropriate
 Sign endorsement overleaf: you must read the endorsement declaration before signing
 Return completed form with supporting documents (if required) to the Program Manager
Incomplete and/or undocumented applications for program variations will not be accepted.
Guidelines
Program Leave (Section 3A)
 Leave from a program may be granted to participants
 Leave is generally restricted to a period of three months; applications for longer periods will only be
considered under exceptional circumstances
 Participants generally need to have completed at least three months of a program before applying
for leave
 Fees will still be payable during any leave period, as per the original terms and conditions of trade
 The same session time / day cannot necessarily be guaranteed when recommencing a program
 If there are no positions available when the participant is due to recommence, they shall be put on a
waiting list and will recommence their program on a first come first served basis
 A participant whose application for leave is rejected or who does not resume their program at the
end of the approved leave period must reapply in the usual manner, for re-admission to the program
Program Deferral (Section 3B)
 A participant enrolled in a program they have not yet commenced can request to defer their program
commencement date, with a minimum of two weeks notice
 Programs can be deferred for a period of up to one year
 Where program fees have been fully paid in advance, the participant will not be affected by any price
increased during the program deferral period
 Where program fees were to be paid monthly in advance, the participant can either:
o Pay the fees as per the schedule and lock in the current program pricing
o Defer the payment schedule to when they will commence the program, without locking in the
current program pricing
 A participant whose application for deferral is rejected or who does not resume their program at the
end of the approved deferral period must reapply in the usual manner, for re-admission to the
program
Program Discontinuation (Section 3C)
 A participant enrolled in a program can request to discontinue their program with a minimum of four
weeks notice
 Participants may be able to transfer credits to other parties, by agreement
 Program fees that have been paid are non-refundable
Submitting the Form
You can submit your completed “Program Variation - Application Form” by mail, fax, email (scanned copy) or
in person.
Your application is not valid unless signed and dated. If you are signing the application on behalf of the
applicant, a certified copy of your authority to act on their behalf must be attached.
Post:
nLIVEn
PO Box 1112
Hartwell, 3124
Fax:
+61 3 8610 1243
Email:
info@nliven.com.au
In person:
Suite 8
1175 Toorak Road
Camberwell, 3124
Suite 8, 1175 Toorak Road Camberwell, Victoria, 3124 Australia • www.nliven.com.au
PO Box 1112 Hartwell, Victoria, 3124 • Telephone +61 3 9889 7777 • Facsimile +61 3 8610 1243
nLIVEn Pty Ltd
Program Variation Application Form
SECTION 1: PERSONAL DETAILS
Family Name:
Given Name:
Date of Birth:
Address:
Telephone:
Email:
SECTION 2: PROGRAM DETAILS
Program Details:
Commencement Date:
Expected Completion Date:
SECTION 3A: PROGRAM LEAVE
I wish to apply for leave between ____/____/______ and ____/____/______ because:
You must attach independent supporting documentation if required.
Program Authority
____/____/______ Approved
 Yes  No
Name: ________ Signature: ________ Date: ______
SECTION 3B: PROGRAM DEFERRAL
I wish to defer the commencement of my Program:  Yes
Requested re-commencement date: ____/____/_______
Length of deferral? _____ month/s
SECTION 3C: PROGRAM DISCONTINUATION
I no longer wish to be enrolled with nLIVEn for the following reason(s):
Please cancel my enrolment. I am aware that I may have to waitlist for an available session time if I
decide to participate at a later date.
Effective: ____/____/_______
SECTION 5: ENDORSEMENT
I have read and understood the guidelines and advice on this application form. I certify that all
information, including supporting documentation and certificates, is correct. In signing this form I
understand that the details are protected by the confidentiality terms and conditions of my Program
Agreement.
Client Signature: _____________________________
Date: __________________
Suite 8, 1175 Toorak Road Camberwell, Victoria, 3124 Australia • www.nliven.com.au
PO Box 1112 Hartwell, Victoria, 3124 • Telephone +61 3 9889 7777 • Facsimile +61 3 8610 1243