Enrolment - Direct Debit Agreement - Re-enrolment

Name(Required)

First (Add Above) Last (Add Above)

Email(Required)

Phone(Required)

Address(Required)

Street Address (Add Above) Address Line 2 (Add Above) City (Add Above) State / Territory (Add Above) Post Code (Add Above) Country

Recommencement Date(Required)

Please select a recommencement date within 3 months from your current expiry date.

Consent(Required)

I agree to the Direct Debit Agreement outlined below.

1. By agreeing to the Direct Debit Request, you authorise Stripe to arrange for funds to be debited from your nominated financial institution account (the nominated account is the Debit/Credit Card used to make payment of your course deposit). Stripe is acting as an agent for Australian College of Weight Management Pty Ltd, and Stripe does not provide any goods or services to you.

2. Stripe or Australian College of Weight Management Pty Ltd will give you at least 14 days’ notice in writing of any changes to the terms of the drawing arrangements.

3. Stripe will keep information relating to your nominated account confidential in accordance with Stripe’s privacy policy, except where required for the purposes of conducting direct debits with your financial institution. Your personal information will be transferred by Stripe to the United States. If you do not want to provide your personal information to Stripe in connection with the Direct Debit Request, Stripe will not be able to debit your nominated account.

4. Where the due date is not a business day, Stripe will draw from your nominated financial institution account on the next business day.

5. It is your responsibility to:
-Ensure your nominated account can accept direct debits;
- Ensure that there are sufficient clear funds available in the nominated account to meet each drawing on the due date;
- Advise immediately if the nominated account is transferred or closed or if your account details change;
- Arrange a suitable payment method if Stripe or Australian College of Weight Management Pty Ltd cancels the drawing arrangements;
- Ensure that all authorised signatories nominated on the financial institution account to be debited authorise the Direct Debit Request.

6. Subject to the terms and conditions of your nominated financial institution account and your agreement with Australian College of Weight Management Pty Ltd, you may alter the drawing arrangements. Such advice should be received by Australian College of Weight Management Pty Ltd at least 7 business days prior to the drawing date for any of the following:
- Changing your nominated account number
- Altering a DDR schedule
If you require further information, please contact Australian College of Weight Management Pty Ltd. Alternatively, you can also contact your financial institution or confirm your financial rights.

7. If you believe that there has been an error in debiting your account, you should notify Australian College of Weight Management Pty Ltd immediately. The College will notify you in writing of its determination and the amount of any adjustment that will be made to your nominated account (if any). Stripe will arrange for your financial institution to adjust your account accordingly. You may also contact your financial institution.

8. The details of your drawing arrangements are contained within this form:
- Total Re-Enrolment Fee (all qualifications): $2,700.00
- Deposit options and instalment schedules are confirmed within this form you are signing.

9. Stripe reserves the right to cancel the drawing arrangements if three consecutive drawings are dishonoured by your financial institution. In such cases, Australian College of Weight Management Pty Ltd will arrange an alternative payment method with you. Refer to your financial institution’s terms regarding dishonour fees. The College may also charge additional fees in line with its Terms of Enrolment.

10. Additional Compliance
- Student Support in Cases of Financial Hardship: If you experience financial difficulty or hardship in maintaining payments, please contact Australian College of Weight Management Pty Ltd as soon as possible. We will work with you to identify reasonable options, including referral to external financial counselling services if required.
- Complaints and Appeals: If you have concerns about the payment process or believe that you have been treated unfairly, you may lodge a complaint under the College’s Complaints and Appeals Policy. This process ensures fair resolution and aligns with your rights as a student.
- Review and Governance: This agreement will be reviewed annually to ensure it remains fair, transparent, and effective. Updates will be communicated to you in line with the notice provisions outlined above.
- Accessibility and Inclusion: A plain-language summary of this agreement is available on request. You will also receive a copy of the signed form electronically, and it will be stored securely in accordance with the College’s data management policies.

Stripe Privacy Policy: https://stripe.com/au/privacy

Financial Rights: https://financialrights.org.au/factsheets/direct-debits-from-credit-cards-factsheet/

ACWMAH Terms of Enrolment: https://www.collegeofweightmanagement.com.au/terms-of-enrolment/

Direct Debit Schedule(Required)

Payment Plan 1 = $200 Deposit paid today and $30 per week starting 7 days after deposit is paid in full

Payment Plan 2 = $200 Deposit paid today and $50 per week starting 7 days after deposit is paid in full

Please Note: Adjustments will be applied as per the terms of the Direct Debit Agreement and Schedule above so please ensure you select the correct option that suits your enrolment and financial needs.We cannot accept upfront payments of more than $1500, upfront is not an option on some courses and if selected incorrectly above you will be placed on the correct option based on your Enrolment Agreement, Course Start Date and terms of the Direct Debit Agreement.

Re-enrol Deposit(Required)

Paid Today

Weekly Instalment(Required)

Please Note: Choosing the lower payment plan will extend your payment plan beyond your course duration.

Credit Card(Required)

Card Details

Cardholder Name

Signature(Required)