TO BE COMPLETED BY THE STUDENT
(Required fields* must be filled out for a sucessful submission)
   
Title
Family Name
Given Name
Unit no / Street no
Street
Suburb
State
Post Code
Country
Email
Phone no
Did you apply throught an ECA registered agent?


If yes, please indicate the agent's company name
 
Student Number
CURRENT: Which course would you like to be refunded?
Course Name Start Date Fees Paid
Select Location
 
 
Section 2: Refund Details
Other (Please specify)

Please attach the suitable documents

Section 3: Payment mode (How did you pay for your tuition fees?)
Bank Cheque
Bank Deposit
Credit Card*
EFTPOS
TT
BPAY
The refunds,if approved, will be paid to the person or institution who/ which originally paid the fees. We cannot transfer fun ds to any other party. Please note that the beneficiary name can only be the name of the person or institution who/ which paid the original tuition fees.

*Unless payment was made by Bank Cheque, Bank Deposit, EFTPOS and TT, refunds must be credited back to the same Credit Card acc ount. Please include a copy of your Credit Card statement as evidence of card details and payment. An online transaction history cannot be accepted as a form of verification. For any other payment method, please supply your bank account details.

I certify that the information provided above is true and correct. If I currently have any fines or fees that have not been pai d, I agree that my refund will first be used to pay these debts.
 
Section 4:Bank & Credit card details
Telegraphic Transfer - Overseas Bank details for Refund (Offshore)
Bank Name
Account Name
Account No
Branch Name
BSB
Swift Code
   
Details for Credit Card Refund  
Credit Card Holder
Credit Card Type
Credit Card No
Expiry Date
   
Bank cheque - Onshore  
Beneficiary Name
Amount Required $
Bank Name
Account Name
Account No
Branch Name
BSB
Swift Code