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Required fields are marked with an asterisk *
Complete this form to request a refund if you need to withdraw from VacSwim after enrolments have closed. 
When blank, this form is classed as official. When completed, this form is classed as official sensitive. This form is an official record of the Department of Education.
Lease
Renew lease?

Enter your P-number
Enter your first name
Enter your last name
Enter your email address
Enter your mobile number

You must submit a separate form for each child.
Enter the child’s first name
Enter the child’s last name
Date of birth Enter the child’s date of birth or select the date using the calendar symbol
Select the VacSwim program your child was enrolled inYou must make a selection
Do you know the location of the VacSwim program your child was enrolled in?
You must make a selection
What is the reason for your refund request?You must make a selection
500Enter details to support your response
Upload supporting evidence. Refund requests without evidence will not be processed.
Drag files here or select files.
Remove File
You must upload supporting evidenceSelect files up to a total of 20MB in size. Files must be jpeg, .png, .doc, .docx, .pdf or file

Tick the box
Tick the box
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The 'Save for later' function allows you to save your progress for an incomplete form.

You will not be able to submit the form until all mandatory fields are complete. You can access the incomplete form from the 'My forms' section of the 'Ikon forms' dashboard.

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