SCIC - Refund Application Form

Student Refund Application Form
- Your application for a refund will be considered based on SCIC's Fees & Refunds Policy and Procedure. Please ensure that you have read and understood this document before submitting this form.
- You can find the policy and procedure in the Student Handbook or on the SCIC website at www.scic.nsw.edu.au.
- Please make sure that you attach sufficient evidence to support your refund request.
Refund Request Reason (s)*

My visa was refused by the Department of Home Affairs. (Please attach a copy of the visa refusal letter)I am cancelling my course more than 28 days before the course commencement date.I am cancelling my course between 1 and 28 days before the course commencement date.I am cancelling my course on or after the course commencement date.I have compassionate and compelling reasons for cancelling my course. (Please attach supporting evidence)Other
Student ID*
Please only fill the last 4 digits of your student ID
Student name (as shown on passport)*

First NameLast Name
Course*
Contact phone number*

e.g. +614XXXXXXXX
Email*

Confirmation Emailexample@example.com
When written cancellation request is received on or after course commencement date, no refund.
Other reasons - Please specify: (Please attach supporting evidence)
Refund amount requested*
Please provide details of the amount and nature of refund requested
Provide any further information to support your refund request in this space
List the documentary evidence you have attached with your application here*
File Upload

Cancelof

Bank Details

If this application is approved, provide Bank Account details for payment: (Refunds will only be paid via electronic transfer
Is this refund pay to overseas bank or Australian Bank*

Overseas BankAustralian Bank
Bank Name*
Payee's Address
Payee's account name*
BSB
Payee's account number*
Swift Code If applicable
IBAN Code If applicable
Payee's address (no special character such as "*", "/", "-"*
If local currency or AUD is not available in the international transfer, what currency would you prefer (AUD, GBP, EUR)*
I authorise refunded amounts to be deposited into the above nominated account.
Students name*
Students signature*

Clear
Student Declaration
- I have read and understood SCIC's Fees & Refunds Policy and Procedure.
- I accept that the decision made in response to my refund application will be based on this policy and procedure.
- The information I have provided in this document is a true and accurate.
- I have provided supporting documentation to support my refund application.
- I understand that I can access SCIC's Appeals processes if I am not satisfied with SCIC's decision about by refund request.
- I understand that SCIC's Student Fees & Refunds processes do not remove my right to take action under Australia's consumer protection laws.
Students name*
Students signature*

Clear
Date*

DayMonthYear
Date
Should be Empty:

Student Refund Application Form

Bank Details

Student Declaration