Linx - REFUND APPLICATION FORM

REFUND APPLICATION FORM
About this form

This form is to be used when making an application for a refund. All refunds will be processed as per the information included in the International Student Handbook about fees and refunds. Provision of bank details below are taken to mean that you authorise payment to this account.
Name*

Given name/sMiddle NameSurname
Student ID*
Phone number/s
Email address
example@example.com
Address
Refund to:*

Australian accountOverseas account
Account name*
BSB*
Account number*
Country (if overseas)*
Bank name (if overseas)*
IBAN / SWIFT (If overseas)*
Currency (If overseas)*
Residence address (If overseas)*
Reason for refund*
Student signature

Clear
Date

MonthDayYear
Date
Agent Signature

Clear
Date

MonthDayYear
Date
Should be Empty: