Refund Application Form

Before you fill in this form, please read ABILITY English Terms and Conditions of Enrolment and Refund Policy

Student and Course Details

Full Name :
DOB:

Student ID:

Address :
Tel:

Mobile:

Email:

Course :
Start Date:

End Date:

I wish to apply for a refund of my unused prepaid tuition fees for the course described above.
My reason for applying for a refund is: (please tick the most appropriate one)
Tick
appropriate
box

Reasons for claiming the refund

Documents* to be submitted with the

Refund Application Form

Visa application is refused

Cancellation of Enrolment form

Proof of visa refusal from DIBP or Embassy (Consulate);
Copy of Passport

Written notice of withdrawal provided 28 days or

more before a course commencement

Cancellation of Enrolment form

Statement outlining the reasons for withdrawal;
Copy of Passport

Written notice of withdrawal provided less than 28

days before start date of continuing term

Cancellation of Enrolment form

Statement outlining the reasons for withdrawal;
Copy of Passport

I did not commence the course on the start date

and subsequently provide notice of withdrawal
from the course

Cancellation of Enrolment form

Statement outlining the reasons for withdrawal;
Copy of Passport

Other (please specify below)

Cancellation of Enrolment form

Relevant evidence;
Copy of Passport

* All the required documents must be submitted with this application form, otherwise it may cause delays in
application outcome decision or refund not being granted.

Refund Application Form version 3 (July 2014)

ABILITY English CRICOS Provider Code 01530K

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Method of Refund Payment:

I authorise ABILITY English to pay the refund I am eligible for to the person and bank account
nominated herein:
Myself
A third party - Name: _____________________________Relationship:__________________
Please ensure all details are fully completed to avoid delay in receiving your efund.
Account Name:
Account No:
Bank:
Banks Address:
Banks BSB No (within Australia only)
or SWIFT Code (for overseas
transfer):
Account Holders Address:

Please transfer my fees as a credit to my new course at ABILITY English or MEGT Institute
(please attach Letter of Offer and payment details for the new course)

Student Declaration:
I have read and understood ABILITY English Terms and Conditions of Enrolment, including its Refund
Policy. I declare that the information I have supplied on and with this form is, to the best of my
knowledge, true and correct. I understand that personal information collected on or with this form will be
used for the purpose of assisting to make an informed decision on my request.

Student Signature ______________________________________

Date:______/______/______

Parent Signature

Date:______/______/______

______________________________________

(If the student is under 18 years of age, signature of parent or legal guardian is also required)

OFFICE USE ONLY

Campus Manager

APPROVED
Comments:

NOT APPROVED

Date:______/______/______

Signature:
Notice of decision sent to student:

Actioned by Finance

Name:

Date:______/______/______

Payment processed by ___________________

Date:______/______/______

Refund amount ___________________

Notify Admissions of refund payment details (for PRISMS reporting)

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