Unable to collect grant cheque form:
Please complete and return this form to
Fees Office, Aras Ui Chathail, NUI Galway.
Phone 091-492386 / Fax 091-495553
Name of County Council or VEC:
Date:
Student Name:
Student I.D. Number:
Course Code:
I am a registered student at NUI Galway and in full attendance. However, I am
unable to call in person to the Fees Office to collect my maintenance cheques from
the above named council because
I would appreciate if you would forward
my first [ ], (in September / October 2014)
my second [ ], (in January 2015)
my third [ ], (in April 2015)
or all three [ ] grant cheques
I hold a bank account with
AIB [ ]
BOI [ ]
] please
] tick
] appropriate
] box
] please tick
] appropriate box
Account Number:
Branch Sort Code:
We can only forward your cheque to AIB or Bank of Ireland. If you do not hold a
bank account with either bank please forward 3 stamped self addressed envelopes
along with this form to the Fees Office, NUI Galway.
Signed:
For Fees Office use only:
1st Cheque sent by ________ on __ / __ / 2014. Amount €__________
2nd Cheque sent by ________ on __ / __ / 2015. Amount €__________
3rd Cheque sent by ________ on __ / __ / 2015. Amount €__________
Fees Office, NUI Galway
Fax to: 091-495553 or scan to fees@nuigalway.ie