This form allows us to raise an invoice for a third party (e.g. an employer) to pay some or all of a student’s fees. Please complete all relevant fields in this form to assist us to process your invoice in a timely manner. You must have JavaScript enabled to use this form. Company name Company address Address 2 Suburb State - None -Western AustraliaAustralian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoria Postcode ABN Contact name Contact telephone Contact email Billing email Authority and purchase order details Please select whichever applies For apprenticeship or traineeship For all other students Purchase order number Upload purchase order Upload One file only.20 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.15 MB limit per form. Student details This authority is for the following student(s). If you wish to receive one invoice for multiple students, you will need to enter the details of more students after completing the details for the first. If you have more than nine students, please upload a list below. Last name First name Student ID Date of birth Campus - None -ExmouthCarnarvonGeraldtonBatavia Coast Maritime InstituteTechnology ParkNorthamMooraMerredinKalgoorlie Student list If you wish to receive an invoice for multiple students, please upload a list of the students here. Please ensure you include student name, ID, date of birth and campus for each student on the list. Upload student list Upload One file only.20 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.15 MB limit per form. Please specify the course (or courses) that the student(s) will be undertaking, that this invoice authorisation applies to. Third party payment authorisation Acknowledgement and authority In signing this payment authority form, the third party acknowledges that they are accepting full responsibility for the payment of all fees and charges relating to the above named student’s enrolment at Central Regional TAFE. Any rescindment of this authority must be provided to Central Regional TAFE in writing and any fee incurred or invoiced prior to this rescindment authority will remain the responsibility of the third party. In the event of non-payment by a third party the student will be liable for any fees outstanding at Central Regional TAFE. Authorised staff name Position Date Submit Leave this field blank