REFUND REQUEST FORM

PERSONAL DETAILS

Student ID Number : *

Family Name : *

Given Name : *

Mobile : *

Email Address *

Course : *

HOW TO COMPLETE YOUR APPLICATION

To successfully submit your application, follow these steps:

Fill out the application form provided and sign the declaration.
Provide ALL the necessary supporting evidence.
Students who wish to apply for a refund must submit this application before Census Date.
Approved refunds will be paid within 20 days from the date of receipt of this application.
All refunds will be made in Australian Dollars.
ASA will not agree to transfer unpaid tuition fees to any other provider or student.

INTERNATIONAL STUDENTS

Important Note: Postponing, suspending, or discontinuing enrolment may impact your student visa.
ASA is obligated to notify the Department of Education and Training through PRISMS in accordance with the ESOS Act 2000.
To adhere to visa conditions, international students must:

Maintain a valid visa.
Complete their course by the specified expected completion date on the eCoE.
Provide the Institute with address details within seven days of arrival or any address changes.
Sustain a full-time study load.
Abide by the maximum number of hours allowed to work on the student visa.
Maintain Overseas Student Health Cover or its equivalent.

REFUND DETAILS

Reason for refund * : (original supporting evidence documents must be attached.g. visa refusal)

*

DETAILS OF REFUND

Original Payment Method *

Bank Transfer

Credit Card

Other

Australian Bank Account:

Account Name *

Account No *

Bank Name *

BSB No *

Overseas Bank Account:

Full Account Name: *

Account No *

Bank Name *

Account Holder Address. *

SWIFT Code: *

IBAN: *

Branch Address: *

If this refund payment is to be made to a party other than the student, the student MUST complete this authorisation section

I

(Student's full name)

Authorise payment of this refund to

(Full name of individual or organization)

Evidence Upload

STUDENT DECLARATION

I declare that, to the best of my knowledge, the information provided in this form (and attachments) is accurate and comprehensive. I understand that incomplete information may lead to the return of my application. I acknowledge that it is my responsibility to furnish all required documentary evidence.

Student's signature *

clear

Date : * +