Withdrawal, Refund and Insurance Opt-out Request Form

General Information

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Date

As per our policies, the date that you submit this request impacts your refund eligibility. Please review the relevant policy here: https://continue.yorku.ca/support/policies/ before submitting a withdrawal request.

Student Number(Required)

0 of 9 max characters

Type of Request

Overpayment Refund Request

Please fill in the refund request details below. Please confirm that your student portal is showing an overpayment before submitting a request.

Residence/Meal Plan or Optional Fees Refund

Other Refund Request Details(Required)

Please provide details on what you are requesting a refund for.

0 of 255 max characters

Opt Out and/or Refund Request for Insurance

Please note: All students are required to have health insurance that covers the length of their course.

Opt Out of Insurance

Please note: The deadline to opt out of insurance is the end of week one (1) of your program. If you do not cancel your insurance with us by that deadline, insurance will be ordered for you, and you will be required to pay the fee. If you have your own personal insurance that will last the length of your program, you may request to cancel insurance with us.

Proof of Insurance(Required)

Please upload proof that you already have insurance. Proof of insurance must clearly indicate the student’s name, the policy number, the start and end date of the policy and must be valid for the entire length of the program.

Drop files here or

Max. file size: 8 MB, Max. files: 4.

Request a Refund for Insurance

Please confirm that you have already paid for insurance before requesting a refund by reviewing your payments in the Student Portal. See below for instructions.

Withdrawal

Important Note: You will need to submit a separate withdrawal form for each program that you wish to withdraw from. At the end of this form, you will be sent back to submit another withdrawal form.

When is the start of your program?(Required)

Program Withdrawal Information

Program Name (Professional Education)(Required)

Program Name (English Language Institute)(Required)

Other Reason for Program Withdrawal(Required)

Enter a short description for your withdrawal reason. You can provide longer comments below.

0 of 255 max characters

Upload Visa Denial Letter(Required)

Please upload a copy of the Visa Denial letter and any other supporting documents.

Drop files here or

Max. file size: 8 MB, Max. files: 8.

Upload Supporting Documents

Please upload a copy of any supporting documents.

Drop files here or

Max. file size: 8 MB, Max. files: 8.

Course Withdrawal Information

Course List(Required)

Please list all of the courses you wish to withdraw from. Please include the full course code (e.g. CSBA1020).

Upload Supporting Documents

Please upload a copy of any supporting documents.

Drop files here or

Max. file size: 8 MB, Max. files: 8.

Other Comments and Refund Request

Other Comments

Please provide additional details to explain your request.

Payment Information

Please review your payments and check your balance before filling in the refund request details below. Follow the steps below to do so.

Log in to the Student Portal here: https://my.continue.yorku.ca/portal/logon.do?method=load
On the left sidebar, click on “My Account History”. Review all transactions/payments.
On the left sidebar, click on “My Invoices”. Review any outstanding invoices (money that is still owing).

My Invoices Example:

My Account History Example:

Other Payment Details(Required)

Please provide details on how you paid your tuition.

Please note, if you are eligible for a refund:

Credit Card refunds may require 2-3 weeks for processing.

All payments made through Convera Global Pay or other methods will be returned to the source account whenever possible. Payments made through Convera Global Pay which cannot be returned to the original payee will be refunded by wire transfer and may require approximately 7-8 weeks for processing.

Payment from Canadian Bank (Transfer or Cheque/Money Order/Bank Draft)

Bank Wire Information #1

Please enter the details of the first bank account that you paid from. This must match our records of your payment.

Account Holder #1: Email(Required)

Account Holder #1: Phone Number(Required)

Bank #1: Name(Required)

Please enter the name of your banking institution.

Bank #1: Phone Number(Required)

The following image is an example of how to find the Transit, Institution and Account numbers from one of your cheques.

Bank #1: Transit Number(Required)

This must match the transit number for the
Canadian bank account that you paid from.

Bank #1: Institution Number(Required)

This must match the institution number for the
Canadian bank account that you paid from.

Bank #1: Account Number(Required)

This must match the account number that you paid from.

Bank #1: VOID Cheque/Direct Deposit/Pre-Authorized Debit Form(Required)

Please upload a VOID cheque, Direct Deposit Form or Pre-Authorized Debit Form matching the transit, institution and account numbers for your Canadian bank account. The details must exactly match the account that you paid from.

Most major banks make this form available through their online banking sites. Please contact your bank for details.

Drop files here or

Max. file size: 8 MB, Max. files: 4.

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Bank #1: SWIFT Code

Bank #1: Proof of Payment(Required)

Upload proof of payment. Documents need to clearly identify the payor name and the amount paid.

The account holder name, bank name and bank account number entered into this form must match EXACTLY with the proof of payment that you upload.

Drop files here or

Max. file size: 8 MB, Max. files: 4.

Bank Wire Information #2

Please enter the details of the second bank account that you paid from. This must match our records of your payment.

Account Holder #2: Email(Required)

Account Holder #2: Phone Number(Required)

Bank #2: Name(Required)

Please enter the name of your banking institution.

Bank #2: Phone Number(Required)

The following image is an example of how to find the Transit, Institution and Account numbers from one of your cheques.

Bank #2: Transit Number(Required)

This must match the transit number for the
Canadian bank account that you paid from.

Bank #2: Institution Number(Required)

This must match the institution number for the
Canadian bank account that you paid from.

Bank #2: Account Number(Required)

This must match the account number that you paid from.

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Bank #2: SWIFT Code

Bank #2: VOID Cheque/Direct Deposit/Pre-Authorized Debit Form(Required)

Please upload a VOID cheque, Direct Deposit Form or Pre-Authorized Debit Form matching the transit, institution and account numbers for your Canadian bank account. The details must exactly match the account that you paid from.

Most major banks make this form available through their online banking sites. Please contact your bank for details.

Drop files here or

Max. file size: 8 MB, Max. files: 4.

Bank #2: Proof of Payment(Required)

Upload proof of payment. Documents need to clearly identify the payor name and the amount paid.

The account holder name, bank name and bank account number entered into this form must match EXACTLY with the proof of payment that you upload.

Drop files here or

Max. file size: 8 MB, Max. files: 4.

Bank Wire Information #3

Please enter the details of the third bank account that you paid from. This must match our records of your payment.

Account Holder #3: Email(Required)

Account Holder #3: Phone Number(Required)

Bank #3: Name(Required)

Please enter the name of your banking institution.

Bank #3: Phone Number(Required)

The following image is an example of how to find the Transit, Institution and Account numbers from one of your cheques.

Bank #3: Transit Number(Required)

This must match the transit number for the
Canadian bank account that you paid from.

Bank #3: Institution Number(Required)

This must match the institution number for the
Canadian bank account that you paid from.

Bank #3: Account Number(Required)

This must match the account number that you paid from.

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Bank #3: SWIFT Code

Bank #3: VOID Cheque/Direct Deposit/Pre-Authorized Debit Form(Required)

Please upload a VOID cheque, Direct Deposit Form or Pre-Authorized Debit Form matching the transit, institution and account numbers for your Canadian bank account. The details must exactly match the account that you paid from.

Most major banks make this form available through their online banking sites. Please contact your bank for details.

Drop files here or

Max. file size: 8 MB, Max. files: 4.

Bank #3: Proof of Payment(Required)

Upload proof of payment. Documents need to clearly identify the payor name and the amount paid.

The account holder name, bank name and bank account number entered into this form must match EXACTLY with the proof of payment that you upload.