FAX: 269.471.3228 EMAIL: sfs@andrews.edu
NAME
________________________________________________ CONTACT INFO ____________________________________
DATE ________________ ID NUMBER
_ ____________________ SIGNATURE ______________________________________
STEP 1: SEMESTER > Fall Spring Summer Non-current
STEP 2: AMOUNT > Full Partial $___________________ (maximum 3 refunds per semester)
STEP 3: TYPE > Wire Transfer- attach wire detail form ($15 USD fee) Refund to credit card used _____________________ (date)
E-Refund-create refund profile in TouchNet® Paper refund check-complete Steps 4 & 5.
STEP 4 : MAKE CHECK PAYABLE TO > Student Other ________________________________________________ (Name)
STEP 5: DELIVERY > Pick up Mail ________________________________________________ (Street)
____________________________________________(City/State/Zip)
OFFICE USE ONLY
Refund amount $ _______________ Approved by___________ Entered__________ Mailed on ____________ by _____________
PROCESSOR’S COMMENTS
3/24/2020
REFUND REQUEST FORM
Minimum 3-5 business days Processing Time