International Programs Refund Request

* Required Information

*Student Family Name:

*Student Given Name:

*Student Date of Birth: Ex: mm/dd/yyyy

GRCC Student Identification Number: 8449

*Refund Type:

*Method of Refund:

Bank Wire Transfer Information

Account Name:*

Account Number:*

Bank Name:*

Bank Address:*

Bank City:*

Bank Country:*

Swift Code or Routing Number:

Check

Check to be issued to:*

Address:*

City:*

Country:*

Postal Code:*

Requestor Information (if not student)

Name:

Address:

City:

Country:

Postal Code:

Email:

If not student, relationship to student

Please Note: Credit Card refunds will go back to the credit card used for original payment.

Information for: