Refund Request Form

This form must be completed for all refunds. It takes approximately 10 to 14 business days to process a refund. It may take longer before the credit appears on the patron's credit card statement. *Category "7" requires an explanation. You must fill out fields before submitting this form!

This refund is subject to a $5 service fee, see refund policy.
Reason
Requirement
Adjustment
Service Charge
1-Illness Doctor's note May be pro-rated No
2-Moved out of
         Arlington Heights		 New address May be pro-rated No
3-Schedule conflict
         w/AHPD programs 		Refund form May be pro-rated No
4-Schedule conflict -
         general		 Refund form May be pro-rated Yes
5-Class status change
         (closed, cancelled, transferred)		 Refund form None No
6-Satisfaction guarantee Refund form None No
7-Other (*explanation) Refund form May be Pro-Rated Yes
     *Explanation: MUST provide written explanation
     
       
Note: If original form of payment changes, refund will be made in check form.
Please make refund payable to:
       

Participant's Name		    
   

Program Title
Program ID Code
Program Start Date
       

Contact Name
Phone
Email
 

  

Office Use Only: