Repayment Form - Goethe-Institut

CANCELLATION CONDITIONS

Withdrawals must be submitted in writing before the course begins. Refund amount: 80%.
Refunds follow the original payment method. E-wallet or QRIS payments will be refunded via bank transfer.
Refunds are processed within 14–30 business days after the written statement is received.

Course

E.g.: Extensive Course Tuesday + Thursday A1.1

Course Periode

March–April 2025 (super/intensive course); March–June 2025 (extensive course)

Customer Number

0062xxxxxx

Full Name

Date of Birth

Mobile Number

Email Address

Payment Method

Payment Receipt

NB: The total size of all uploaded files may not exceed 20 MB.

Bank Account Number

Account Holder's Name

Bank Branch

Reason of Refund

Terms and Conditions of Cancellation

I am aware of the terms and conditions of cancellation.

* required

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