Refund Application Form SC5.1

Refund Application Form

SC5.1
Student Name*
Full Name
Student ID
Email address*
example@example.com
Course Code Title*
e.g. CPP30321 Certificate III in Cleaning Operations
Workplace / STATE if Workplace based training (if Workplace based training)*
e.g. Brisbane Airport / QLD
Date of Withdrawal*

DayMonthYear
Enrolment status*

I have enrolled and commenced my courseI have not commenced my courseI currently owe fees and want them reconsidered
Reason for refund request*
Credit Card/Debit Card Refund

I acknowledge I paid by credit or debit card (Visa or Mastercard) AND if approved, the refund will be to the same card as that used for payment.
ONLY FILL OUT BELOW 'BANK TRANSFER REFUND' DETAILS IF YOU DID NOT PAY BY DEBIT OR CREDIT CARD
Bank Transfer Refund

If you paid by bank transfer AND if approved, the refund will be to the same bank account as that used for payment.
Account Name
BSB Number
Account Number
Refund amount in AUD*
e.g. 123
Bank details verification (Attach a copy of your bank statement OR email to rto.admin@au.issworld.com)

Cancelof
OR
Take a photo/snap shot of your Account name, BSB number and Account number
Student Signature*

Clear
Printed Name*
Date*

DayMonthYear
Date
Should be Empty: