COMPLETION/WITHDRAWAL FORM

CESSATION OF STUDY AND APPLICATION FOR REFUND OF DEPOSITS

PERSONAL AND PROGRAMME PARTICULARS
Name
NRIC/Passport No. Student ID
Contacts
Tel No.
Email Address
Mobile Phone No.
Programme Intake
COMPLETION/WITHDRAWAL PARTICULARS
IMPORTANT NOTES AND MANDATORY DECLARATION
Signature of student
Date
Please read the following carefully and sign and date here before submitting this form.
I hereby undertake that I am fully aware of and will be bound by the Sunway University
rules and regulations for this application.
I declare that all the particulars relate to me and are correct.
1. Application for refund must be made within 12 calendar months from your last day of
study.
2. The return of your student ID card is mandatory if one has been issued to you, and
also your library card (if you have registered as a student in 2008 or earlier), failing
which a penalty of RM50.00 and RM25.00 will be imposed respectively.
3. All Sunway University equipment/property in your possession (e.g., books borrowed
from the Tun Hussein Onn Library) must be returned to the relevant departments.
4. Please submit this form to the:
Registry (Malaysian Student) or International Office (International Student)
Name
SUPPORTING DOCUMENTATION
I enclose herewith a letter/copy of air-ticket/other supporting document(s) for this
application.
1
Completion Seek employment Further study Others
Please state your plan after completing the programme stated above.
Withdrawal Financial
Academic
Please state the reason for withdrawing from your programme.
Medical
Seek employment
Others
Please state programme Please state plan
Please state name of institution
Please state reason
REFUND PARTICULARS (IF APPLICABLE)
Please specify the payment option for refund (subject to bank charges)
By cheque
By bankdraft
By telegraphic transfer
Crossed cheque Open cheque
Currency
Currency SWIFT code
Bank
Account no.
Please state name, branch and country
Please specify the payee for refund
Self
Family member Father Mother Guardian (as specified in your application form)
Name NRIC/Passport no.
Please specify the collection method for refund (Note: Not applicable for telegraphic transfer)
Collect personally or by the payee
Collect on behalf of payee (Note: A letter of authorisation is required)
(unable to cope with programme)
As in NRIC/Passport.
Please complete all sections on this form in BLOCK CAPITALS.
(Version: 05022013)
Please provide full address. (Note: overseas address using P.O. Box is not allowed)
Post by mail
Transfer to other institution
TERMS AND CONDITIONS

Eligibility criteria

You are eligible to apply for refund of deposits if:
You do not have any outstanding payment with Sunway University.
You are fully aware and accept that you will comply with the rules and regulations of Sunway University for the refund of deposits.

Processing time

The processing time of this application will take approximately 20 working days from the date of release of the final semester results
(excluding Saturday, Sunday and public holidays) and/or confirmation of completion of programme.


For enquiries please call +603 7491 8622

Malaysian student: Extension 8772/8179 (for all programmes)
International student: Extension 3863 (for all programmes)

Or send an email to registry@sunway.edu.my (please provide your name as in NRIC/Passport, student ID number, programme and intake).


Data protection

The protection of personal privacy is an important concern to Sunway University, and any personal data collected on this form will be
treated in accordance with the current data protection policies of the institution.
2
FOR OFFICE USE ONLY
* For students who are enrolled in the Intensive English Programme and one other programme.
Verification from School / Academic Department
INTERNATIONAL OFFICE
Cancelled student ID card
Cancelled library card
Verified passport (for cancellation of student pass)
Received a copy of the passport information page
Received a copy of the passport entry stamp/offer letter
Signature
Date
Name
Signature
Date
Name
THE REGISTRY
Cancelled student ID card
Cancelled library card
Updated student and programme/subject statuses (in the EMS)
Printed and issued letter of notification
Remarks Remarks
Approval from Centre for English Language Studies (if applicable*)
Signature
Date
Name
Position
Signature
Date
Name
Position
Remarks Remarks
Signature
Date
Name
Position and Department
Remarks
Acknowledgement by interviewer (only required if interview is not conducted by School/Academic Department)
This section must be endorsed by a senior staff member from the relevant School or Academic Department.
Note: Remarks in this section will be considered as official and entered into EMS