Acceptance Of Offer / Payment Agreement Form Payment Options (Page 2 of 2) in pdf

AUSTRALIAN STUDENTS

Direct Deposit

Please find attached a copy of my direct deposit receipt of $_______paid on ___/___/_____ (dd/mm/yy),

being payment for semester _____________ in the __________________program, paid to the following

account:

Bank Name:

WESTPAC

Bank Address:

109 St. Georges Terrace, Perth WA 6000

Account Details:

SAIBT/CELUSA Student Fees Account

BSB Number:

036 000

Account Number:

773884

Swift Code:

WPACAU2S

Credit Card Payment

All credit card payment will incur a 1.5% credit card payment surcharge

Please deibt my credit card with $________________ being payment for semester _________________

in the __________________________program. My credit card details are as follows:

Visa

Mastercard

Bankcard

(please circle one only)

Credit Card Number:

________________________________________________________

Name on Card:

________________________________________________________

Card Expiry:

________________________________________________________

Cardholders Signature:

___________________________________Date:_________________

Payment Agreement:

Option 1

Pay 50% of tuition fees in Week 1 and the balance in Week 7 of the Semester.

A late payment fee of $50.00 will be charged if fees are not paid by the dates specific. An additional

charge of $25.00 will be charged for every week that the payment is late.

Option 2

Make four payments each of 25% of tuition fees. Payments are due Week 1, Week 5, Week 9 and

Week 13 of the semester.

Credit Card Payments Only (Visa, MasterCard and Bankcard accepted only).

A late payment fee of $200.00 will be charged if fees are not paid by the dates specified.

I have read and understood all of the information supplied to me in the SAIBT brochure/ SAIBT website. I

have also read and understood the SAIBT tuition fee refund policy as stated in the Conditions of

Enrollment in the SAIBT brochure/ SAIBT website and I agree to abide by this policy.

Signature __________________________________________________________________________

Name of Parent/ Guardian (if applicable)__________________________________________________

(Parent or Guardian must sign the acceptance form if the student is under 18 years of age)

OFFICE USE ONLY: Orientation information sent, date_______________ Credit and transaction

processed date______________ Copy of Option Agreement forwarded to Accounts, date_____________

South Australian Institute of Business and Technology

Tel (61 8) 8302 1555

Fax (61 8) 83021557

University of South Australia – City East campus

Email saibt.info@unisa.edu.au

Brookman Building, North Terrace, Adelaide 5000

Web

South Australia

Acceptance Of Offer / Payment Agreement Form Payment Options Page 2

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