Fee Refund Form
(domestic students only)
Applicant Name: _____________________________ Student ID: __________________________________
Domestic tuition fees…..
Other…………………….
…….
Please specify: ______________________________________________
Was the payment made on your behalf? (Please select one) YES NO
If yes please provide the name and details of the payee including their bank account details where the refund is to
be credited
If no please provide your account name and details including your bank account details where the refund is to be
credited
Payee account name: __________________________________________________
Signature of student: _______________________________ Date: ______________________________
________________________________________________________________________________________________
For office use only
Amount: _________________________________________ Authorised by: ______________________________
Signature: ________________________________________ Date: ______________________________
Email: ______________________________________________________________
Phone: _____________________________________________________________
What New Zealand bank account is the refund to be credited to?
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IMPORTANT NOTICE
Refunds cannot be processed without the following documentation
Refunds can take up to 14 working days to appear in the nominated bank account
If your AUT fees were paid by Study-link please DO NOT complete this form as refunds to Study-link are
automatically identified by the University
I would like a refund of my (please tick one)
Copy of your bank statement verifying your account number OR
Screen capture of your bank account OR
Bank deposit slip
