Refund Request Form

The refund process will take 4 to 6 weeks

Section 1/3

First Name Last Name Student Address Student Mobile No Student Email Address

Section 2/3

What Is your agent Name Total Amount you paid for the requested Service? Refund for AccommodationCourse feePick-upExamInsurance What is the reason you are asking for refund ? Have you got your GNIB already? * (Did you go to immigration and collected your GNIB?)YesNo 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 following address: info@llcentre.ieYes I have SentNo I haven't sent

Section 3/3

Bank Information

Receiver’s Name Receiver’s Address Receiver’s Bank name Receiver’s Bank Address Receiver’s Bank Country Receiver’s Iban Receiver’s Account number Receiver’s Bank SWIFT Address / BIC Receiver’s Bank Code Message/ Additional Information