Payment Instalment or Fee Extension Request Form

Payment Instalment or Fee Extension Request Form
Details
Student ID Number:*
Name*
Email*
example@example.com
Course:*
Group No:
Course start date:

DayMonthYear
Date
Section 1 – Student to complete
I request an extension for payment of the following:
Invoice Number:
Amount:
Reason:*
(Please attach any supporting documentation)

Cancelof
How and when you want to pay:*
Failure to make a payment on the adjusted date will incur additional late fees as per the fees policy.
Section 2 – Student Declaration
I understand that my application for an extension on fee payment will be processed in accordance with winslow college Student Fees and Charges Policy.Signing this form does not mean that it is approved, you need to wait for Winslow College's approval communication.
Print name:*
Signature:*

Clear
Date*

DayMonthYear
Date
Should be Empty:

Details