Refund Processing and Information Verification Form

Please read the terms listed in the Enrollment Agreement and the Cancellation, Withdrawal, and Refund Policy before signing any contract.

Personal Information

First Name

Last Name

Phone Number

E-mail

Street Address

Apartment/Unit Number

City

State / Province

ZIP Code

Country

Program Information

Which program did you enroll in

If "other program", which one?

Start date

End date

Payment amount

Payment Method

Why are you requesting a refund?

I have read, understood and agree to the terms listed in the Cancellation and Refund Policy

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Always Enabled

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Refund Processing and Information Verification Form

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