Philadelphia

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Philadelphia Chinese Language Withdrawal Form

Complete this form in its entirety.

Registrant's Details
First name:
Middle Name:
Last name:

I understand that if for any reason I cannot attend the course ater the first class, I may submit a withdrawl form and recieve a 50% refund. I may also qualify for a credit voucher instead of a refund for the first class. No refunds are given after the second class meeting.

I submit a withdrawl form to recieve a 50% refund

I submit a withdrawl form for a credit voucher. Vouchers are valid for one year.

The refunded check or voucher will take upto 3 weeks to process . The refund will only be send by check.

The name should be endorsed to
Address check will be mailed to:
Street Number and Name
City:
State:
ZIP:
Contact Email Address:
Contact Phone Number:
Reason for cancellation:

Submit

Philadelphia Chinese Language Center
1801 Butler Pike, Apt#41
Conshohocken, PA 19428