Griffin Refund Form v.July2021

CHECKLIST.

Please collect below said documents before you start completing this form.
- Student all Information should match with signed offer letter / as in College records (Check signed offer letter)
- If Bank Account is not in the name of Student. One additioan form. REFUND REQUEST-ALTERNATIVE PAYEE FORM is also required. Please complete that form (can downlaod from website) then you can come back here to complete this form, as you will be required to upload that form with this application.
- Fee Deposit Receipt (isssed by Bank)
- Student Passport copy
- Student CoEs copy
- Visa refusal letter or other evidance for refund reasons.
If anything not ready with you, please colelct that and return back to complete this form.
Are you ready with documents as bper checklist

YesNo

REFUND FORM
Griffin Student ID*
Title (Mr, Mrs, Ms etc)*
Given name*
Last name*
Date of BIRTH*

DayMonthYear
Date
Telephone number*
Mobile Number*
E-mail address*
example@example.com

Course/s*
Course Start Date o(Planned Start date in Griffin College) *

DayMonthYear
Date
Course Finish Date (Planned Finish Date in Griffin College)*

DayMonthYear
Date

Refund to*

Student bank accountOthers Bank account (Please also complete Alternative Payfee form )
Bank Details*

Australian BankOutside Australia Bank Account

Australian Bank details
Name of Bank*
Account Holder Name*
BSB*
Account number*

Outsdie Australian Bank Details
Bank name
SWIFT code*
Account number*
Account Holder name*
BANK Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Bank Country*
Bank Phone number*

Area CodePhone Number

Reason for refund:*
Note: This application must be supported by additional documents that can be varified.
Electronic Consent: Tick here to confirm that you have declared and provided correct infromation.*

Yes
Student Signatures*

Clear
Date*

DayMonthYear
Date

Alternative Payfee form (Downlaod from Grififn College website)-Required Only if bank account is not on the name of Student.

Browse Files

Cancelof
Reason: Visa refusal letter or any other documents*

Browse Files

Cancelof
Paid fee receipt*

Browse Files

Cancelof
Passport copy *

Browse Files

Cancelof
Any one CoE copy of Griffin College*

Browse Files

Cancelof
Total Deposit Made
Agent Email ID for this application, if no agent , please enter student Email ID*

Confirmation Emailexample@example.com
Please verify that you are human*
Should be Empty: