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STUDENT CAMPUS - Refund Request Form
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* Indicates required question
Student Name
*
Your answer
Student ID
*
Your answer
Student Address
*
Your answer
Phone
*
Your answer
Email
*
Your answer
Requests refund for
*
Course
Accommodation
Book
Transfer
Other:
Total amount paid for the service requested
*
Your answer
What's the name of your agent ?
*
Who did you buy your course from ?
Your answer
When did you make your payment to Student Campus?
*
MM
/
DD
/
YYYY
Have you got your Insurances already ?
*
Governamental Insurance that STUDENT CAMPUS provides
Yes
No
What is the reason you are asking for refund ?
*
Your answer
Have you got your GNIB already ?
*
Did you go to immigration and collected your GNIB ?
Yes
No
If you didn't get it - Did you get your GNIB Denied ?
Was your GNIB refused ?
Yes
No
Clear selection
If you get your GNIB refused, could you please send an email with the immigration letter copy and copy of all your passport pages to the address below
info@studentcampus.ie
Yes, I sent it
No, I did not send it
Clear selection
Receiver's Name
*
Responsible for the acount who is getting the money
Your answer
Receiver's Address
*
Personal address of the person who is responsible for the account
Your answer
Receiver's Account Number
*
Your answer
Receiver's IBAN number
*
Your answer
Receiver's Bank SWIFT Address / BIC
*
Your answer
Receiver's Bank Name
*
Your answer
Receiver's Bank Address
*
City, State, Country
Your answer
Receiver's Bank Code
*
Your answer
Other Comments
*
Your answer
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