2025 - Online Refund Request Form

I request a refund for the following:

Please select the type of refund:*

Amount*

Reason: (Please attach any supporting documentation)*

Support documentation upload

Refund Method - Please provide your account details or the account details of the nominated third party where you wish the refund amount to be received.*

Onshore Transfer (Australian Bank)Overseas Transfer (Transfer fees applied)

Please fill the correct and complete details below to avoid delays

Account Name*

BSB*

Account Number*

Country*

Beneficiary Name*

Beneficiary Address*

Bank Name*

Bank Address*

Account Number*

IFSC CODE (if applicable)

SWIFT CODE

IBAN Number (If applicable)

To know if you need to provide the IBAN number, please refer to the given link.

Countries that require IBAN number for fund transfers

Acknowledgement*

I understand that my request for a refund will be processed in accordance with the Fees, Charges & Refund Policy.I understand that Glen Institute will not transfer any funds to a third party unless I explicitly request it in writing, in which case Glen Institute shall be released of any responsibility in relation to the refund once the funds have been trabsferred as requested.Signing this form does not mean that it is approved, you need to wait for Glen Institute's approval communication.

Signature*

Date*

Date

This refund amount is:*

ApprovedDenied

Does the student meet the refund criteria as per the refund policy?*

YesNo

The refund approved amount is:

Comments

Student will receive these comments in the rejection or approval email

Evidence reviewed:

Visa refusal letterStudent withdrawal/ transfer approvalOther

Amount paid by the student

Date paid by the student

Date

Print Name*

Position*

Signature*

Approval Date*

Date

Due Date for Clearance*

Date

Refund amount paid/clear

YesNon/a

Logged by: (A/C Personnel)

Signature

Date

Formal Letter/Email Sent

YesNo

Date

SMS Updated

YesNo

Date

Case closed by

Signature

Online Refund Request Form

Section 1 - Student Details

Section 2 - Refund Details

Section 3 - Account Authorisation (Admin Use Only)

Section 4 - Clearance (A/C Use Only)

Section 5 - Finalisation (Admin Use Only)