Office of Student Accounts - Valparaiso University

Office of Student Accounts > Student Refund Check Request Form

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STUDENT REFUND CHECK REQUEST FORM

Semester of Refund	Fall Spring Summer 1 Summer 2
Type of Student	Law Undergrad Grad
Date
Amount of check
Make Check Payable to:
First Name
Last Name
Mail to:
Name
Street
City
Zip code
	Do not mail, I will pick up my check at the finance office.
Student ID #
Telephone #
Student Name (if different from above)
Notes or instruction