Application for Refund of International Fees This form is for full fee paying international applicant / student who is withdrawing prior to enrolment or discontinuing from a course after enrolment. Note: the refund process takes 2 - 4 weeks.

Monash ID: ___________________________

Title: Mr  Miss  Ms  Mrs  Other: __________

Surname: _____________________________

Given Names: __________________________________

Date of Birth: __________________________ Address: _______________________________________________________________________________ ______________________________________________________________________________________ Postcode: _____________________________

Country: ______________________________________

Phone: _______________________________

Email: ________________________________________

Withdrawal / discontinuation from:

 English Language

 Foundation Year

 Diploma

 Monash University

Course Name(s) ________________________________________________________________________ Reason(s) for withdrawing / discontinuing - provide relevant supporting documentation (eg. visa refusal letter, medical certificate, etc):

 Condition not met

 Visa refusal

 Late registration not approved

 Deferment not approved

 Preferred course not offered

 Transfer to another provider

 Course no longer offered

 Financial

 Overpayment

 Medical reasons

 Intermission

 Enrolment excluded/suspended

 Failed to re-enrol

 Withdrawn in good standing

 Unit(s) withdrawn

 Non GTE student

 Other – please specify _____________________________________

Refund of the Overseas Student Health Cover (OSHC) 

Where you have not arrived and have never resided in Australia, Monash University will claim the OSHC refund from Allianz Global Assistance on your behalf.



Where you have arrived or have resided in Australia, it is your responsibility to claim the OSHC refund from your OSHC provider/insurer directly.

Please ensure you have read and understood the attached Monash University and Monash College Pty Ltd Fees Refund Policy before signing the declaration below. I declare that the information provided on this form is true and complete and that it is my responsibility to provide all necessary documentation to support my request for refund. I agree and have read and understood the “Monash University and Monash College Pty Ltd Fees Refund Policy” attached to this form.

Signature of student:_____________________________

Date: _____________________

The information on this form is collected for the primary purpose of assessing your application for a refund. If you choose not to complete all the questions on this form, it may not be possible for Student Finance to process your application. You have a right to access personal information that Monash University holds about you, subject to any exceptions in relevant legislation. If you wish to seek access to your personal information or inquire about the handling of your personal information, please contact the University Privacy Officer on (03) 9905 6011 or by email: [email protected]. Ver. May 2015

Student ID: ________________________ Q1. Is the original payment made by a credit card?  Yes – go to option (D) below  No – go to Q2. Q2. Is the refund to be made payable to:  You (student)? – EFT/TT/DRAFT/CHEQUE - choose only one option: (A) or (B) or (C) below  Another person, sponsor or institution? – DRAFT/CHEQUE ONLY - go to option (C) Where a bank draft or cheque is sent to a person, sponsor or institution nominated by you, Monash University/Monash College Pty Ltd shall be deemed to have discharged any obligation it may have in relation to the refund of fees to you and accepts no responsibility for you not receiving the benefit of such refund of international fees. Monash University/Monash College Pty Ltd is not responsible for you not receiving monies from the nominated recipient.

(A) Refund into an Australian bank account – Electronic funds transfer (EFT) Account Name: _________________________________________________________________________ Name of Bank: __________________________________________________________________________ Branch: ________________________________________________________________________________ BSB number:

Account number:

(B) Refund into an overseas bank account – Telegraphic transfer (TT) Note: Refunds are normally made in the currency of your country of permanent residence. Monash University is not liable for any bank fee charges and variance from foreign exchange rates fluctuations.

Beneficiary Name (Your name): ______________________________________________________________ Beneficiary Address (Your address): ___________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Your Account Name: _____________________________________________________________________ Your Account number: Bank Name: ____________________________________________________________________________ Bank Street Address: _____________________________________________________________________ ______________________________________________________________________________________ SWIFT Code (eg. HSBCHKXXXX): __________________________________________________________ And IFSC Code (for Indian bank accounts): __________________________________________________ (C) Refund by overseas bank draft / cheque Note: Refunds are normally made in the currency of your country of permanent residence with the exceptions of drafts to PR China, India and cheques within Australia in AUD and non-tradable currencies where the refund will be paid in USD. Monash University is not liable for any variance from the foreign exchange rates fluctuations.

Draft / cheque payable to - Title: _ _____ Name: ______________________________________________ Address: _______________________________________________________________________________ ______________________________________________________________________________________ (D) Refund by credit card Card type:

 Visa

 MasterCard

Cardholder’s name: ______________________________________________________________________ Credit card number: Expiry Date: _____ / _____ This form can be submitted:

Cardholder’s Signature: ______________________________  In person – Monash Connect on your campus  By fax – +61 3 9543 9314  By mail – Monash Connect, Campus Centre, 21 Chancellors Walk, Monash University, VIC 3800, Australia

The following refund policy is applicable to students who have received the International Student Course Agreement issued before 8 July 2013.

Refunds for Monash University and for Monash College Pty Ltd Diploma and Foundation Year Courses (excluding English Language courses) How refunds will be made a) The refund amount is calculated after all outstanding debts to Monash have been paid and after clearance of all relevant cheques and receipt of all relevant telegraphic transfers or direct deposits. b) The refund will be made to the same person or party from whom the payment was received on your behalf. c) Refunds will be paid within four (4) weeks of receiving a written claim from you, except for circumstances set out in Section 1(b) below in which case the refund will be paid to you within two (2) weeks of the day on which the course ceased being provided. Alternatively, you may be offered enrolment in another course by Monash. You must choose whether you would prefer a full refund of course fees, or to accept a place in another course. If you choose placement in another course, you must sign a document to indicate that you accept the placement. d) A refund will normally be made in the currency of your country of permanent residence and payable in that country. Exceptions include non-tradable currencies (where the refund would normally then be paid in USD) or payment to another Australian educational institution. Monash is not liable for any variance due to foreign exchange rate fluctuations. e) Any equipment issued to you for your use during your course must be returned in an appropriate condition, or the replacement value of the item will be deducted from any refund amount. 1. When full refunds may be made: A full refund of all course fees paid for future study periods (including deposit fees for courses to be undertaken in futur e study periods as part of a packaged offer) will be made: a) in the event that the offer set out in the International Student Course Agreement (the Agreement) is withdrawn by Monash prior to your enrolment for the course; b) where Monash is unable to provide the course in the Agreement and you do not accept an alternate course; c) where you were not able to meet a condition of the offer set out in the Agreement; d) where you are a commencing student and withdraw or discontinue from your course more than four (4) weeks prior to the commencement of teaching or more than four (4) weeks prior to the commencement of a research program; e) when illness or disability prevents you from commencing study in a course in this Agreement; f) if Monash makes this offer on the basis of incorrect or incomplete information being supplied by you and this Agreement is terminated prior to commencement of any study; g) when death of a close family member (parent, sibling, spouse or child) occurs and this prevents you from commencing the course; h) at the discretion of the Manager, Student Finance at Monash, when other special or extenuating personal circumstances prevent you from commencing a course; i) where you have been excluded by Monash for failure to meet course progression rules or for disciplinary reasons (but only in respect of fees paid for that part of the course not yet delivered at the date the exclusion from learning opportunities takes effect); or j) if you are a continuing student and re-enrol, then withdraw before the Census date as described in http://www.monash.edu.au/enrolments/dates/census.html. Documentary evidence must be provided in support of an application for a refund under any of the above provisions. 2. When partial refunds may be made: A partial refund of the course fees paid for current and future study periods will be made to you if: a) you give less than four (4) weeks notice prior to the commencement of teaching in the study period of the course of your inability to undertake the course; b) you withdraw from a course prior to the Census date; c) you withdraw from a course prior to four (4) weeks of commencement of a research program; or d) there is a refusal by the Australian Government authorities to grant you a visa and the refusal was a reason that directly or indirectly caused you to default under this Agreement. In cases (a), (b) and (c) above, Monash will refund the course fee paid for the relevant study period (and any deposit fees for courses to be undertaken in future study periods as part of a packaged offer), less an administrative fee of A$1,000. In case (d) above, Monash will refund the course fee paid for the relevant study period (and any deposit fees for courses to be undertaken in future study periods as part of a packaged offer), less an administration fee. This administration fee shall be the lesser of:

(i) 5% of the total amount of pre-paid fees Monash has received before the day of default in respect of the course(s) now not being undertaken; and (ii) the amount of A$500. 3. When no refund will be made There will not be any refund of course fees paid if you: a) withdraw from a course after the Census date of the study period for which you are enrolled, and in that case, you will only be refunded any course fees paid in advance for future study periods; b) are a Higher Degree by Research student who withdraws from a course more than four (4) weeks after the commencement of the course but before the Census date; and in that case, you will only be refunded any course fees paid in advance for future study periods; c) are otherwise in breach of the Agreement; d) in lieu of refund, elect to accept enrolment in an alternate course offered to you by Monash where Monash is unable to provide the original course; or e) if Monash is prohibited from doing so by relevant sanctions laws. In cases (a) and (b) however, Monash will refund any course fees paid in advance for future study periods not now to be undertaken. 4. Complaints and appeals concerning refund application In the event that you wish to contest a Monash rejection of your request for a refund, you have access to established dispute resolution procedures, which do not circumscribe your right to pursue other legal remedies. These dispute resolution procedures can be found at http://www.monash.edu.au/fees/contacts/grievances-appeals.html

Refunds for Monash College Pty Ltd English Language Courses How refunds will be made a) The refund amount is calculated after all outstanding debts to Monash have been paid and after clearance of all relevant cheques and receipt of all relevant telegraphic transfers or direct deposits. b) The refund will be made to the same person or party from whom the payment was received on your behalf. c) Refunds will be paid within four (4) weeks of receiving a written claim from you, except for circumstances set out in Section 1(c) below in which case the refund will be paid to you within two (2) weeks of the day on which the course ceased being provided. d) A refund will normally be made in the currency of your country of permanent residence and payable in that country. Exceptions include non-tradable currencies (where the refund would normally then be paid in USD) or payment to another Australian educational institution. Monash is not liable for any variance due to foreign exchange rate fluctuations. e) Any equipment issued to you for your use during your course must be returned in an appropriate condition, or the replacement value of the item will be deducted from any refund amount. 1. When full refunds may be made A full refund of all course fees paid for future study periods will be made: a) if Monash College Pty Ltd does not accept your application for enrolment; b) where Monash College Pty Ltd receives a written notice of cancellation of your enrolment more than four (4) weeks prior to your commencement of your course; or c) if Monash College Pty Ltd is unable to deliver your course and unable to offer you a place in a suitable alternative course, save that in situations (a) and (b), an administration fee of A$250 will be retained for each English Language course and an administration fee of A$100 will be retained for each Introductory Academic Program course not proceeded with. 2. When partial refunds may be made A partial refund will be made to you where: a) you give less than four (4) weeks written notice of cancellation of your enrolment in the course; and where that notice is received by Monash College Pty Ltd prior to the commencement of the course; or b) there is a refusal by the Australian Government authorities to grant you a visa and the refusal was a reason that directly or indirectly caused you to default under the Agreement. In case (a) above, Monash will refund the course fees paid for future study periods less the equivalent of five (5) weeks course fee and less an administration fee. The administration fee will be A$250 for each English Language course and will be A$100 for each Introductory Academic Program course not proceeded with. In case (b) above, Monash will refund the course fee paid for the relevant study period (and any deposit fees for courses to be undertaken in future study periods as part of a packaged offer), less an administration fee. This administration fee shall be the lesser of:

(i) 5% of the total amount of pre-paid fees Monash has received before the day of default in respect of the course(s) now not being undertaken; and (ii) the amount of A$500. 3. When no refund will be made No refund of course fees paid will be made: a) if you fail to enrol in your course; b) written notice of your cancellation of enrolment in the course is received by Monash after the commencement of the course; c) if you are otherwise in breach of the Agreement; d) if in lieu of refund, you elect to accept enrolment in an alternate course offered to you by Monash where Monash is unable to provide the original course; or e) if Monash is prohibited from doing so by relevant sanctions laws. 4. Transfer of fees in lieu of refund In lieu of a refund being paid to you, course fees paid by you may be transferable to formal award courses at Monash University and Monash College Pty Ltd provided that: a) no transfers will be made to another English Language course provider, any other institution other than Monash, or for or on behalf of any other student; b) you must request such a transfer, in writing, to Monash College Pty Ltd; c) you must provide to Monash College Pty Ltd evidence of acceptance into a formal award course at either Monash University or Monash College Pty Ltd; and d) in the event of such a transfer, Monash College Pty Ltd may retain the applicable administration fee for each course you will not now be undertaking. 5. Complaints and Appeals In the event that you wish to contest Monash’s rejection of your request for a refund, you have access to established dispute resolution procedures, which do not circumscribe your right to pursue other legal remedies. These dispute resolution procedures can be found at http://www.monashcollege.monash.edu.au/monashcollege/assets/doc/mcgrievance-policy-proc.pdf

The following refund policy is applicable to students who have received the International Student Course Agreement issued from 8 July 2013 onwards.

Refunds for Monash University and Monash College Pty Ltd (Diploma and Foundation Year) How refunds will be made a) The refund amount is calculated after all outstanding debts to Monash have been paid and after clearance of all relevant cheques and receipt of all relevant telegraphic transfers or direct deposits. b) The refund will be made to the same person or party from whom the payment was received on your behalf. c) Refunds will be paid within four (4) weeks of receiving a written claim from you, except for circumstances set out in Term 1(c) in which case the refund will be paid to you within two (2) weeks of the day on which the course ceased being provided. d) A refund will normally be made in the currency of your country of permanent residence and payable in that country. Exceptions include non-tradable currencies (where the refund would normally then be paid in USD) or payment to another Australian educational institution. Monash is not liable for any variance due to foreign exchange rate fluctuations. e) Any equipment issued to you for your use during your course must be returned in an appropriate condition, or the replacement value of the item will be deducted from any refund amount. 1. When full refunds may be made: A full refund of all course fees paid for future study periods (including deposit fees for courses to be undertaken in future study periods as part of a packaged offer) will be made: a) in the event that the offer set out in this Agreement is withdrawn by Monash prior to your enrolment in the course; b) if Monash makes this offer on the basis of incorrect or incomplete information being supplied to you and this Agreement is terminated prior to commencement of any study period; c) where Monash is unable to provide the course in the Agreement and you do not accept an alternate course offer, if made; d) when illness or disability prevents you from studying the course; e) when death of a close family member (parent, sibling, spouse or child) occurs and this prevents you from studying the course; f) where you have been excluded from Monash for reasons other than misconduct pursuant to University Statute 4.1 – Student Discipline; or g) at the discretion of the Manager, Student Finance at Monash, when other special or extenuating personal circumstances prevent you from studying the course. Documentary evidence must be provided in support of an application for a refund under any of the above provisions. 2. When partial refunds may be made: A partial refund of course fees paid for current and future study periods will be made to you if: a) you did not satisfy a condition of the offer set out in the Offer Details section of Part A of this Agreement; b) you give at least four (4) weeks’ notice prior to the commencement of teaching/research in the first study period of the course of your inability to undertake the course; c) there is a refusal by the Australian Government authorities to grant you a visa and the refusal was a reason that directly or indirectly caused you to default under this Agreement; d) you give less than four (4) weeks’ notice prior to the commencement of teaching/research in the first study period of the course of your inability to undertaken the course; e) you withdraw from or discontinue your course prior to the Census date, as described in http://www.monash.edu.au/enrolments/dates/census.html (Census date); or f) at the discretion of the Manager, Student Finance at Monash, when other special or extenuating personal circumstances prevent you from studying the course. In cases a) and b) above, Monash will refund the course fee paid for the relevant study period and any deposit fees for courses to be undertaken in future study periods as part of a packaged offer, less a fee of A$500 per course now not to be undertaken. In case c) above, Monash will refund the course fee paid for the relevant study period and any deposit fees for courses to be undertaken in future study periods as part of a packaged offer, less a fee. This fee shall be the lesser of (i) 5% of the total amount of pre-paid fees Monash has received before the day of default in respect of the course/s now not being undertaken, and (ii) the amount of A$500. In cases d) and e) above, Monash will refund 50% of the course fee paid for the relevant study period and any deposit fees paid for courses to be undertaken in future study periods as part of a packaged offer), less a fee of A$500 per course now not to be undertaken. In case f), Monash will refund that part of the course fee considered appropriate, in the complete and unfettered discretion of the Manager, Student Finance at Monash.

3. When no refund will be made There will not be any refund of course fees paid if: a) you withdraw from a course after the Census date of the study period for which you are enrolled; b) you are a Higher Degree by Research student who withdraws from a course more than four (4) weeks after the commencement of the course; c) you have been excluded by Monash for misconduct pursuant to University Statute 4.1 – Student Discipline. d) you are otherwise in breach of this Agreement; e) in lieu of refund, you elect to accept enrolment in an alternate course offered to you by Monash where Monash is unable to provide the original course. In this case, you will sign the necessary documents to this effect; or f) the University is prohibited from doing so by relevant sanctions laws. In all cases save for f) however, Monash will refund any course fees paid in advance for future study periods not now to be undertaken, less a fee of A$500. 4. Complaints and appeals concerning refund application In the event that you wish to contest Monash’s rejection of your request for a refund, you have access to established dispute resolution procedures, which do not circumscribe your right to pursue other legal remedies. These dispute resolution procedures can be found at http://www.monash.edu.au/fees/contacts/grievances-appeals.html This agreement, and the availability of complaints and appeals processes, does not remove the right of the student to take action under Australia's consumer protection laws.

Refunds for Monash College Pty Ltd - English Language Courses How refunds will be made The refund amount is calculated after all outstanding debts to Monash have been paid and after clearance of all relevant cheques and receipt of all relevant telegraphic transfers or direct deposits. a) The refund will be made to the same person or party from whom the payment was received on your behalf. b) Refunds will be paid within four (4) weeks of receiving a written claim from you, except for circumstances set out in item 1(c) in which case the refund will be paid to you within two (2) weeks of the day on which the course ceased being provided. c) A refund will normally be made in the currency of your country of permanent residence and payable in that country. Exceptions include non-tradable currencies (where the refund would normally then be paid in USD) or payment to another Australian educational institution. Monash is not liable for any variance due to foreign exchange rate fluctuations. d) Any equipment issued to you for your use during your course must be returned in an appropriate condition, or the replacement value of the item will be deducted from any refund amount. 1. When full refunds may be made A full refund of all course fees paid for current and future study periods will be made: a) if Monash College Pty Ltd does not accept your application for enrolment; b) where Monash College Pty Ltd receives a written notice of cancellation of your enrolment more than four (4) weeks prior to the commencement of your course; or c) if Monash College Pty Ltd is unable to deliver your course and unable to offer you a place in a suitable alternative course, save that in situations a) and b), the administration fee will be retained for each English Language course not proceeded with. 2. When partial refunds may be made A partial refund will be made to you where: a) you give less than four (4) weeks written notice of cancellation of your enrolment in the course; and where that notice is received by Monash College Pty Ltd prior to the commencement of the course; or b) there is a refusal by the Australian Government authorities to grant you a visa and the refusal was a reason that directly or indirectly caused you to default under this Agreement. In case (a) above, Monash will refund the course fees paid for future study periods less the equivalent of five (5) weeks course fee and will retain the administration fee for each English Language course not proceeded with. In case (b) above, Monash will refund the course fee paid for the relevant study period (and any deposit fees for courses to be undertaken in future study periods as part of a packaged offer), less a fee. This fee shall be the lesser of (i) 5% of the total amount of pre-paid fees Monash has received before the day of default in respect of the course/s now not being undertaken, and (ii) the amount of A$500.

3. When no refund will be made No refund of course fees paid will be made if: a) you fail to enrol in your course; b) written notice of your cancellation of enrolment in the course is received by Monash after the commencement of the course; c) you are otherwise in breach of this Agreement; d) in lieu of refund, you elect to accept enrolment in an alternate course offered to you by Monash where Monash is unable to provide the original course. In this case, you will sign the necessary documents to this effect; or e) the University is prohibited from doing so by relevant sanctions laws 4. Transfer of fees in lieu of refund In lieu of a refund being paid to you, course fees paid by you may be transferable to formal award courses at Monash University and Monash College Pty Ltd provided that: a) no transfers will be made to another English Language course provider, any other institution other than Monash, or for or on behalf of any other student; b) you must request such a transfer, in writing, to Monash College Pty Ltd; c) you must provide to Monash College Pty Ltd evidence of acceptance into a formal award course at either Monash University or Monash College Pty Ltd; and d) in the event of such a transfer, Monash College Pty Ltd may retain the applicable administration fee for each course you will not now be undertaking. 5. Complaints and appeals concerning refund application In the event that you wish to contest Monash’s rejection of your request for a refund, you have access to established dispute resolution procedures, which do not circumscribe your right to pursue other legal remedies. These dispute resolution procedures can be found at http://www.monashcollege.monash.edu.au/monashcollege/assets/doc/mcgrievance-policy-proc.pdf This agreement, and the availability of complaints and appeals processes, does not remove the right of the student to take action under Australia's consumer protection laws.

Ver. May 15