Financial Hardship Application

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WA Financial Hardship Form

Financial Hardship Criteria
You must meet and provide evidence for ALL of the following:
  1. Your income must not exceed the Department of Human services income thresholds for the low income health care card, as outlined below:
    • Single, no children - Weekly income $656 - Total income in the eight-week period prior to applying $5,248
    • Couple combined, no children - Weekly income $1,127 - Total income in the eight-week period prior to applying $9,016
    • Single, one dependent child - Weekly income $1,127 - Total income in the eight-week period prior to applying $9,016/li>
    • Couple combined, one child - Weekly income $1,161 - Total income in the eight-week period prior to applying $9,288
    • For each additional Child add - Weekly income $34 - Total income in the eight-week period prior to applying $272
  2. You must not have any disposable income to pay the fees via instalments without compromising your ability to meet your basic living needs or those of your dependents.
  3. There is no basis for concluding that your financial circumstances are likely to change within a reasonable period (eg 12 months).
Financial Hardship Definition
A person is considered to be in severe financial hardship only where they are unable to provide food, accommodation, clothing, medical treatment, or other basic necessities for themselves and/or their dependants. Forms of entertainment or recreation are not basic necessities.

Financial Hardship Assessment
The assessment of whether you qualify for a fee waiver is made on the basis of your individual circumstances and those of any dependent family members. Subject to the exceptional circumstances outlined below, a fee waiver cannot be given unless ALL the following criteria are met. Where these criteria are not met, instalment plans are appropriate and extended payment periods may also be considered.
Exceptional circumstances
Short term hardship or temporary financial difficulty that arises from a sudden change in circumstances does not generally qualify a person for fee waiver consideration. Only in exceptional circumstances should a fee waiver be considered.

The following provides examples of the types of events that may compromise a student’s ability to meet their essential living needs or those of their dependents, (this list is indicative and not exhaustive):
  • The student or family member has a sudden or unexpected health issue or disability.
  • Death of a significant wage earner in the family, where the student had a dependent relationship.
  • Relationship breakdown or domestic violence.
  • Significant events which are likely to last over the duration of the enrolment period and clearly impact on the student’s capacity to provide themselves or dependents with basic necessities such as food, accommodation, clothing, medical treatment and other basic necessities.

An assessment will be made on whether you have adequately demonstrated that hardship exists and is likely to persist over the period of enrolment.

In other circumstances a payment plan should be considered.


Application

Ensure you have read the information above before completing this application.
Name(Required)
Please provide email address which was provided during enrolment
Please provide number which was provided during enrolment
Please indicate your status(Required)
Please indicate the reason for this application(Required)

Supporting documentary evidence

You must provide relevant supporting documentation to evidence your claim, including evidence as to your financial circumstances. The nature of the evidence provided will depend on your individual circumstances.
Income Evidence(Required)
All income (including disposable income) must be evidenced, for at least the past eight weeks period prior to applying. Suggested evidence is listed below, select the evidence you will provide:
Expenses Evidence(Required)
All expenses must be included for at least the past eight weeks period prior to applying. Suggested evidence is listed below, select the evidence you will provide:
Please provide details about all upcoming expenses. i.e. When your next Utilities bill will be issued and how often (quarterly, annually) etc.
Not required. if you have any other information which may assist to explain your situation during the assessment of your application, please provide this information in this space.

Evidence of Income

Evidence of Expenses

I declare that all information provided is true and I have not attempted to misrepresent my financial circumstances.
Clear Signature