Student Fees Paid by Third Party

Student details (to be completed by student)

Student's full name *

Student's date of birth *

Wintec Student ID number (if known)

What is your programme of study? *

Invoice details (to be completed by organisation/company)

Date *

Customer order number *

Contact name *

Invoice to (business name) *

Postal address *

Email address *

Phone number *

Invoice to be charged (to be completed by organisation/company)

Invoice number *

Amount (Inclusive GST) *

Are you paying the full programme fee for the student? *

Yes

List of classes paying for: *

Please attach a copy of the students enrolment offer or indicator of fees: *

Name *

Position *

Disclaimer

By submitting this form, I agree that I am authorised (or have delegated authority) on behalf of the organisation/company to make payment on receipt of invoice for fees specified above and accept liability for fee payment.

Wintec will store your contact details to respond to your query, keep a profile of your interactions with Wintec, and send you promotional material.