Bill credit request form
Complete this form in order to request a credit on your bill. COM must be notified by May 29 in order to receive a credit for June's bill. COM will accept notifications through June 9 in order to receive a credit on the July bill. Credits will not be given if not requested prior to June 9.
Name on Billing statement *
Your answer
Member name(s) *
Your answer
Program(s) enrolled in *
Please credit my bill for the month of June. Lap swimmers will receive 1/3 month credit. All other members will receive 1/2 month credit. Please type your name here as authorization. *
Your answer
If we have questions, what is your email address? *
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy