Student Termination/Cancellation 

Though we hate to see you go, we understand that sometimes it’s necessary. We must receive your cancellation form, completed in full, by the 5th of the month that you wish to be your final month. Prior to turning in this notice, your account must be paid up to date. If we receive notice prior to the final billing, this billing must process as planned. If we receive your notice on the 6th of the month, the following month will be your final. Thank you for your understanding and cooperation. 

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Email *
Student Name *
Person completing form *
Instructor Name *
Lesson Day and Time *
Lesson Location *
Required
Today's Date *
MM
/
DD
/
YYYY
Date of the last lesson that the student will attend.  *
MM
/
DD
/
YYYY
May we ask why you are choosing to leave?  *
We must receive your cancellation form, completed in full, by the 5th of the month that you wish to be your final month. If we receive your notice on the 6th of the month, the following month will be your final. 
*
Prior to turning in this notice, your account must be paid up to date. If we receive notice prior to the final billing, this billing must process as scheduled. *
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