Request edit access
Intention to Withdraw 退費申請表
After filling in the form, one of registration staff will contact you via the e-mail address in two weeks if and only if you provided the family number. 若您提供家庭代碼, 填表後註冊組人員會在兩週內以 E-Mail 與您聯絡。
Reason 原因
Your answer
Applicant English Name 申請人英文姓名 *
Your answer
Applicant E-Mail 申請人電郵地址 *
Your answer
Applicant Phone 申請人電話 *
Your answer
Check Payable to 支票抬頭 *
Your answer
Mailing Address 郵寄地址 *
Your answer
Family Number 家庭代號
Your answer
Student English Names (One student in a line) 學生英文姓名 (每個學生各一行) *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Chinese Language School of Southern California. Report Abuse - Terms of Service - Additional Terms