SECTION 2: To be completed by Licensee Programme Co-Ordinator Date Licensee received Programme Co-ordinator Participant Applicant Assessed Participant Cohort status Applicant (please circle) Licensee Withdrawal Review Member/s (please print) Review notes Withdrawal Continue programme Set leave of absence Withdraw from decision programme (Please Circle) Payment Yes No Decision date liable? TO BE COMPLETED BY LICENSEE PROGRAMME CO-ORDINATOR Reason for Appeal date appeal Appeal notes Appeal Continue programme Set of absence Withdraw from decision programme Yes No Payment Decision date liable CLOSE OF WITHDRAWAL PROCESS *This form needs to be completed by participant and facilitators and submitted to
SECTION 2: To be completed by Licensee Programme Co-Ordinator Date received Licensee Programme Co-ordinator Participant status (please circle) Applicant Assessed Applicant Participant Cohort Licensee Withdrawal Review Member/s (please print) Review notes Withdrawal decision (Please Circle) Continue programme Set leave of absence Withdraw from programme Payment liable? Yes No Decision date TO BE COMPLETED BY LICENSEE PROGRAMME CO-ORDINATOR Reason for appeal Appeal date Appeal notes Appeal decision Continue programme Set of absence Withdraw from programme Payment liable Yes No Decision date CLOSE OF WITHDRAWAL PROCESS *This form needs to be completed by participant and facilitators and submitted to
Seacole%20Local%20Withdrawal%20Request%20Template_0.docx