Examinations Services School Exams - Refund Request Form Exam Board Type of Examination Exam Session /Year International GCSE/ GCE O/L / GCE A/L and IAL ( Please circle the appropriate type of examination) Centre number Candidate Name Candidate Number DOB Tel: – Residence Candidate Address Mobile Email Reason {For refund applications made on medical grounds please attach a medical certificate or complete the relevant section of the board refund application form if applicable i.e. Edexcel Refund application form } Crossed Cheque Payment Instructions Receipt No Name of Payee (as per the bank account name) If the cheque should not be written in the candidate's name please circle relationship to candidate Guardian / Parent / Employer / Other Signature of the candidate Signature of the BC Officer Date Date Subjects/Units to be withdrawn Subjects/units Please turn over for check list Office use only Candidate’s Name…………………………………… Receipt No……………. Date…………….. Signature of the BC Officer…………………………. Please note that medical refund requests made for IGCSE/GCE examinations will be paid upon receipt of approval from the relevant exam board. Examinations Services British Council 49 Alfred House Gardens Colombo 03 T (011) 4521521 E info.lk@britishcouncil.org Examinations Services British Council 88/3 Kotugodalle Veediya, Kandy T (081) 4471188 www.britishcouncil.org/srilanka The United Kingdom’s international organisation for educational opportunities and cultural relations. We are registered in England as a charity. Check List Exam board refund request form British Council refund request form Copy of payment receipt(s) – private candidates Copy of the statement of entry Consent letter from school if the payment is done through the school with receipt numbers Medical Certificate Page 2 of 2