Prep Course Cancellation Form

Complete the following form & "submit"  An email will be sent to the Prep Course Committee, with the current date/time stamp.

Cancellations will be refunded in full if received in writing no later than 7 business days prior to the class.

  I am canceling my registering for:

CQA Prep Course - April 24 & 25  - must be received by April 12th
CSTE Prep Course - April 26 & 27  - must be received by April 14th

  First Name:  Last Name:
  Company:     
  Address:     
                    
  City:             State ZIP
  Phone:            Email: 

   My portion of the payment was calculated as:
           $200.00 - as a TCQAA member
       
   $250.00 - as a Non-member
       
   $235.00 - as a Non-member joining TCQAA

   Payment was by:
        Personal Check   Company Check 
                   Check #
                   Amount  $.00 

  Payment was for:
        One person                  (full refund)
        More than one person  (partial refund)