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 (you will find it on your CoE)*
Phone number/s*

Area CodePhone Number
Email address*

Confirmation Emailexample@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*

DayMonthYear
Date
Agent Signature

Clear
Date*

DayMonthYear
Date
Should be Empty: