443 Norther,-i Avenrre
Sault Ste. Marie, ON P6B 4J3 Canada
lntefnatiOnal StUdent RefUnd FOfm rtos7se2554ext
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2300
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REASON FOR REFUND REQUEST
Denied Study Permit:
tr Upon submission of suffieient prerof of Study Permit denial, ine lueling coprT of originalrefusal, you wi!lLre eonsielerecl for a
refund. Fees will be refunded and returned minus:
S4OO administration fee
{ Unable To Attend/Withdrawal (Before Day 10 of Classes):
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S+00 administration fee
$2,10o withdrawalfee
REQu/iftED DOCUMENTS
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H I have subTnitted copies of required documents as listed below:
B/fyOewritten Sault College lnternational Student Refund Form
fl UnmodifiedVisa Refusai file from lmmigration, RefugeesandCitizenshipCanada
M tra nsferring to a nother school, a copy of the LOA from the College/U n iversity
irj I have scanned all required documents including this form into ONE i111 PDF file
This form must be type-written. We will not accept hand-written forms,
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NAME ,tAsr
ID#
2-3AZ305l *1*,7:Bq-ar>
CURRENT ADDRESS { Please make sure your address is up to date on the Sault College Student Portal)
2a\ h6rr.4be.,rr.6td$, No,b W,*t
(nJ.!a' fl)*1 L?3 v
EMAIL "elr,"s) AGENT
NAIVIT TKUI!KAIVI LTJUT LAIUl,U5 l--
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TERM AND YEAR
[-i ratt lseptemberi 20- Winter (January) 20_ ffimmer(ru aylzo$
l4 i pai,J m;, fees through CIBC iilterirational Student Pay Service or throiigh Fiyw!re
Myfees will be returned to the originating method of payment- Bank charges may apply and will be deducted from the applicable
refund. I do not need to complete any additional pages of this refund form if this was my only method of payment.
n I paid my fees by cash, debit, via the Sault College Student Portal, or via a Canadian credit card. The funds orisinated from a
Canadian bank account or via a beneficiarv with a Canadian bank account
My payment originated from within Canada and my refund will be directly deposited into the Canadian bank account I identify. I
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n Ipaid my fees via international wire transfer OR via a credit card or account from outside of Canada
Mv pavment originated from oufside Canada and rvlll be returned to the country of origin as per the details I provide. Bank charges
may apply and will be deducted from the applicable refund. I will identify the international bank account on page 3.
I hove reod and fully understood the terms ond conditions of the Soult College withdrawol/refund policy.
! confirm that l've provided accurate information and outhorize the refund of my fees to the indicated recipient.
SIGNATURE (Must be by Sault College Student) DATE
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you will be notified via email when your refund has been provided to the Financial [Link] Office fcr proae5slrg.
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443 Northern Avenue ffi*e
Sault Ste. Marie, ON P6B 4J3 Canada
L.7 05.7 59.2554 ext. 2300
f inaircialserdices@[Link]
Refund for payments made from a Canadian account/credit card
I paid my fees by cash, debit, via the Sault College Student Portal, or via a Canadian credit card. The funds originated from a Canadian
bank account or via a beneficiary with a Canadian bank account. My payment originated from within Canada and my refund will be
directly r:lepositecl into the Canadlan hank [Link] I identify. I will complete this page
This form must be type-written. We will not accept hand-written forms.
REFUND INFORMATION
REFUND TO:
I S"f lVrut match address on Sault College student portal] I Beneficiary
FULL NAME EMAIL
ADDRESS
TELEPHONE RELATIONSHIP
AUTHORIZATION AGREEMENT
We hereby authorize The Sault College of Applied Arts and Tech nology to in itiate automatic depos its to ou r account at
thefinanciai institLjtiorr i'rai'ned beiow. Vvealso authorizeTheSauitCoiiegeof AppiiecJAi'tsandTechnoiogytomake
withdrawals from this a{count in the event that a credit entry ls made error.
Further, we agree not to hold The Sault College of Applied Arts and Technology responsible for any delay or loss of
funcjsciuetoincorrectorincompieteinforrnationsuppiiedbyusorbyourfinancial institutionorciuetoanerroron
the part of our financial institution in depositing funds to our account.
This agreement will remain in effect until The Sau lt College of Applied Arts and Tech nology receives a written notice of
canceiiation from u s or from ou r iinanciai in stitution, or u ntii we su bm it a new ciirect ciepos it form to the Sau lt Coiiege
Financial Services Department.
NAME OF FINANCIAL INSTITUTION INSTITUTION NO. NO.
(3 digitsJ
ADDRESS OF FINANCIAL INSTITUTION
SIGNATURE
AUTHORIZED SIGNATURE (Primary) NAME DATE
You will be notifled via email when Tour refund ha5 been provided to the Frnan.r;l Seruices Offiae for procei:ing-
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441 l!(lr rlrPr rl AVPr JllP
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Sault Ste. Marie, ON P5B 4J3 Canada
1.705.759.2554 ext. 2300
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Refund for payments made from an account/credit card outside of Canada
I paid my fees via international wire transfer OR via a credit card or bank account outside of Canada. My payment originated from
outside Canada and will be returned to the country of origin as per the details I provide. Bank charges may apply and will be deducted
It r'rrtr ilre drr!,iiadl)ip reIund. lwill rortir'riele ilris rrape
BANK ACCOUNT HOTDER INFORMATION
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nuLUEn tlAtylc
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following format: Apartment Number, Street Number, Street
, Province/State, Couitiry, arirj Postait'Zip Code
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- 5031-+1"
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AccouNrHoLDERrELEpHoNE
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BANK ACCOUNT INFORMATION
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CURRENCY FOR BANK TO RECEIVE
lEl4nadian nollar I us cort*
BANK NAME .?Aaid Bar&
BANK ADDRESS Bank Address should follow the following format: Apartment Number, Street N umber, Street Name, Street Type (Road,
Avenure, etc.) Street Direction, City, Province/State, Country, and Postal/Zip Code
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BANK TELEPHONE BANK ACCOUNT NUMBER OF ACCOUNT HOLDER
qLl-CIt 006E68q6 t-l
SWIFT CODE CODE (Required for Bank Transfer to INDIA)
uf !800 o )-6Ay
ABA CODE (Required for Bank Transfer to USA) IBAN CODE (Required for Bank Transfer to EUROPE)
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