CREDIT CARD: Please select from the following options.
I paid my fees online through my Student Centre.
The refund will be credited back against the originating credit card - you are not required to provide any further details.
I paid my fees in-person or over the phone
The refund will be credited back against the originating credit card - USQ Financial Services staff will contact you to obtain
full credit card details.
PRIVACY COLLECTION STATEMENT:
Accounts Receivable to Process:
AUD
AUD
AUD
Accounts Payable to Process: Electronic Funds Transfer Telegraphic Transfer
International Student Refund Request
USQ collects personal information to assist the University in providing tertiary education and related ancillary services and to be able to contact you
regarding enrolment, assessment and associated USQ services. The information may be made available to Commonwealth and State agencies and the
Tuition Protection Service Director and Secretary pursuant to obligations under the Education Services for Overseas Student Act 2000 and National
Code or other legislative requirements. Personal information will not be disclosed to third parties other than a USQ approved agent, partner or any
organisation who provides sponsorship to you for your studies, without your consent unless required by law.
EFT (AUSTRALIAN BANK ACCOUNT): Only use if fees were paid by cash, cheque, direct transfer, BPAY or Australia Post.
Original Payment
Date
Basis of Refund Approval / Additional Comments Confirmed and Supported By
Signature - Director, USQ International
Refund request approved in accordance with the Refund of Student Fees Policy and Procedure
Refund
Amount
Original Payment
Date
Refund
Amount
Original Payment
Date
Refund
Amount
Refund
Amount
Request ID
QI / Receipt
Number
QI / Receipt
Number
QI / Receipt
Number
INTERNATIONAL OFFICE USE ONLY:
A hard copy of this document is uncontrolled and may not be the current version.
The latest controlled version can be found on the Financial Services Forms page.
Version 4.0 June 2020
SR#
Accounts Payable Initial & Date
Voucher Number
PS Processed
Accounts Receivable Initial & Date
SF Approved
SF Processed
Financial Delegate Initial & Date
click to sign
signature
click to edit