REFUND REQUEST APPLICATION FORM

Students should refer to the Refund Policy for International and Domestic Students and associated Procedure to ensure they are eligible for a refund prior to completing this form.

All approved refunds will be paid within 28 days from the date of receipt of this submitted request.

All refunds are paid in Australian dollars into the bank account nominated in the written request.

The Institute will not authorise tuition fee transfers to any other institution or to other students.

Please contact Student Services (studentservices@aih.nsw.edu.au) if you have any further queries regarding this application form.

PERSONAL DETAILS

Title: *

Other (please specify) Other (please specify)

Family name: *

First name(s): *

Sex: *

Male

Female

Date of birth (dd/mm/yyyy): * +

Student ID: *

Phone (home/mobile): *

Email address: *

Full Address: *

City: *

State: *

Post code: *

Country: *

Course: *

REFUND DETAILS

Reason(s) for refund: *

Original Payment Method: *

Credit Card

Cohort Pay

Other (please specify here Other (please specify here

BANK DETAILS

(overseas transfers may take longer)

BSB number: *

Bank name: *

Account number: *

Account name: *

Swift code (overseas):

IFSC code (overseas):

IBAN (overseas):

Branch address: *

STUDENT DECLARATION

I declare that the information declared on this form is complete and correct. I agree to the conditions of this refund and declare that I am the person to whom this refund is to be paid.

Student's signature *

clear

Date: *

Privacy: We recommend that you read the AIH's Management of Personal Infomation Policy and associated Procedure published on our website [www.aih.nsw.edu.au]

Valid from March 2020. Details may change. Published [March 2020]. V [1].

The Australian Institute of Higher Education is listed as a Higher Education Provider on the Tertiary Education Quality and Standards Agency’s National Register of Higher Education Providers, provider number (PRV12013). ABN 70117349256. CRICOS Provider No. 03147A.

www.aih.nsw.edu.au