Refund Request Form - PDF

							                                                                                                                                  Office Use Only
                                                                                                                           Processed by             Date


                                                              Refund Request Form
Instructions
Refund requests may be requested in-person, by mail or by fax.
A refund may be requested when:
         1. Official Withdrawal: Students have officially withdrawn from their program within the refund deadline dates (www.ryerson.ca/calendar).
         2. Course Drops: Students have dropped courses within the refund deadline dates (www.ryerson.ca/calendar).

Student Information

Student ID:

Surname:

First Name(s):

 Career

    Undergraduate           Continuing Education          Graduate

 Program:


Refund Information
          I have not received funding.
I have received funding from:

          Bursary                                  Other (include details)

          Scholarship

       Student Loan (i.e., OSAP)                SIN (OSAP Students Only):


Refund Address


    Apt/Suite Number           Street Address




   City                                                                 Province     Postal Code                 Country

   *Please note: Refunds will be processed to a Credit Card when a Credit Card was the method of payment.


Student Authorization
            I understand that refund requests are subject to approval and require 30 business days for processing.


    Student Signature                                                                                                      Date


Student Fees - Office Use Only                                                     Student Financial Assistance - Office Use Only
Course Load:                                                                        Refund:                           Payable To:
Refund:                                          Date:                              Refund:                           Payable To:
Assessed By:                                     Date:                             Assessed By:                       Date:
Comments:                                                                          Comments:



                                                                           Student Fees
                                                     350 Victoria Street, POD 64, Toronto, Ontario, M5B 2K3
                                                         Telephone: 416.979.5015 Fax: 416.979.5236