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This form is to request a refund for the Hockey Victoria State Registration Levy Only.

Please click here to read the Hockey Victoria Refund Policy to determine your eligibility for a refund.

For a refund of the Hockey Australia portion of the levy please click here or contact HA via email: justina.balch@hockey.org.au.

This form is to request a refund for Hockey Victoria State Registration Levy Only.

Member Details

Refund Information

(e.g., Junior, Senior, Senior 5 Game, Junior 5 Game etc.)

Bank Information of the individual receiving the refund

Your bank details are required to process your refund if approved. Please ensure you enter your bank details correctly.

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