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  • Refund Form

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    Gregory Gidza B Mugobera
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    This document is an application for a refund from Midlands State University's Bursar's Department. It requests a refund of $XX and includes the student's registration number, name, program, and contact details. It also lists the required attachments - copies of receipts, national ID, student ID, and a statement. The student must sign to apply for a refund for reasons like termination of studies, deferment of studies, or completed studies. The registrar and bursar must also sign to approve the refund.

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    REFUND FORM

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    This document is an application for a refund from Midlands State University's Bursar's Department. It requests a refund of $XX and includes the student's registration number, name, program, and contact details. It also lists the required attachments - copies of receipts, national ID, student ID, and a statement. The student must sign to apply for a refund for reasons like termination of studies, deferment of studies, or completed studies. The registrar and bursar must also sign to approve the refund.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    21 views1 page

    Refund Form

    Uploaded by

    Gregory Gidza B Mugobera
    This document is an application for a refund from Midlands State University's Bursar's Department. It requests a refund of $XX and includes the student's registration number, name, program, and contact details. It also lists the required attachments - copies of receipts, national ID, student ID, and a statement. The student must sign to apply for a refund for reasons like termination of studies, deferment of studies, or completed studies. The registrar and bursar must also sign to approve the refund.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    MIDLANDS STATE UNIVERSITY

    BURSAR’S DEPARTMENT

    APPLICATION FOR REFUND

    1. FACULTY…………………………………………….

    2. DEPARTMENT……………………………………..

    3. DATE……………/……………/………..2017 BANKING DETAILS

    THE BURSAR ACCOUNT NAME……………………………………

    MIDLANDS STATE UNIVERSITY BANK……………………………………………………..

    P. BAG 9055 BRANCH…………………………………………………..

    GWERU ACCOUNT NUMBER…………………………………

    DEAR SIR

    APPLICATION FOR REFUND : $ STUDENT REGISTRATION NO. ___________.

    I hereby attach copies of all payments made into my account as proof of the excess amount being
    claimed for refund.

    Also find attached a copy of the statement and personal identification documents.

    Thank you

    STUDENT NAME…………………………………….. REASONS FOR A REFUND:

    Cell phone No………………………………… TERMINATION OF STUDIES

    PROGRAMME ………………………………………… DEFERMENT OF STUDIES

    SECURITY CHECK UPS & ATTACHMENTS: COMPLETED STUDIES

    1. COPY OF RECEIPTS PAID EXCESS FEES


    2. COPIES OF a) NATIONAL ID & b) STUDENT ID

    STUDENT’S SIGNATURE……………………………..

    REGISTRAR’S SIGNATURE…………………………………………………….

    BURSAR’S SIGNATURE…………………………………………………………

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