BLC DIPLOMA WITHDRAWAL AND REIMBURSEMENT FORM

Name *

First

Last

Email *

Which BLC centre are you registered to attend? *

Have you already paid any fees for the diploma course?

What amount of fees (in EUR) have you already paid to Juris Angliae Scientia Ltd ("BLC FEES") (leave blank if you have not paid any fees)?

What date did you make the BLC FEES payment on?

Please upload a copy of the BLC FEES payment confirmation

Click or drag a file to this area to upload.

What amount of fees (if any) have you already paid to the local host university ("LOCAL FEES")?

What date did you make the LOCAL FEES payment on?

Please upload a copy of the LOCAL FEES payment confirmation

Click or drag a file to this area to upload.

Name of bank account holder? *

Address (this is REQUIRED by our bank before we can make the refund) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

IBAN/SWIFT account number to which refund should be paid *

What is the BIC bank identification code of the recipient bank?? *

For our own review purposes, would you mind telling us what the reason is for your withdrawal from the diploma course?

Confirmation of intention to withdraw *

I confirm that I wish to withdraw my participation in the 2020-2021 BLC Diploma in English Law and Legal Skills

GDPR Statement *

I consent to having the British Law Centre store and use my submitted information for the purpose of contacting me regarding their events and to provide information about their courses