Refund Request Form
Before completing this form, please read Barrington Training Services Cancellation, Withdrawal and Refund Policy
*For current students, refunds will only be considered once a Withdrawal Form has been completed
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Course Details
Course Code and/or Title
*
Date of Enrolment
*
-
Month
-
Day
Year
Date
Refund Request Details
Name of Requestor
First Name
Last Name
Amount Paid
*
$0.00
Payment Method
*
EFT
Card
Cash
Other
If 'Other', please provide details here:
Reason for Refund
*
Withdrawal before course start
Withdrawal after course start
RTO Cancelled course
Overpayment
Other
If 'Other', please provide details here:
Pleases provide supporting documentation if applicable (E.g. Proof of payment, Medical Certificate)
Browse Files
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Choose a file
Cancel
of
Bank Details
Account Name:
*
Bank Name:
*
BSB:
*
Account Number:
*
Student Declaration
I confirm that the information provided is true and correct. I understand this refund will be assessed in line with the RTO’s refund policy and applicable legislation, and I consent to the refund being processed accordingly.
Signature of Requestor
*
Date signed by Requestor
*
-
Month
-
Day
Year
Date
If under 18 years of age, please obtain parent/guardian signature
Date signed by Parent/Guardian
-
Month
-
Day
Year
Date
Privacy Statement
The personal information supplied and collected in this Form is subject to the Privacy Act 1988 (Commonwealth) and will be treated in accordance with BTS’s Privacy Policy. A full copy of BTS’s Privacy Policy is available on our website.
RTO Use Only
Refund Approved?
*
Yes
No
Amount to Refund:
*
$0.00
Notes/Conditions:
Authorized by (Enter Name)
*
Enter Job Title
*
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: