Online cancellation form.

Membership can only be cancelled by submitting our ONLINE CANCELLATION FORM.
The cancellation form must be received by the 15th of the month to take effect at the end of the same month. (Examples: If we receive your form on May 16 or May 20, you will be billed for the month of June and your cancellation will take place at the end of June.)
THERE ARE NO EXCEPTIONS.
You may withdraw the cancellation at any time before it takes effect but your teacher and/or lesson day and time cannot be guaranteed.
Active membership is mandatory to participate in our events, exams, and recitals. All registration(s) will be withdrawn at the time of membership cancellation.
Champaign School of Music does not provide tuition refunds under any circumstances.
Champaign School of Music reserves the right to terminate membership, in which case, pro-rated tuition will be refunded.

Today's Date

MM

DD

YYYY

Student Name

First Name

Last Name

Parent/Guardian Name

First Name

Last Name

Email

Cell Phone

(###)

###

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Instrument

Cancellation Reason

Describe your teacher's performance

What do you like about Champaign School of Music?

Please tell us how we can improve

What could we have done differently to better accommodate you?

Would you like to further discuss your comments with a manager?

yes

no

Print name of legal guardian or student

First Name

Last Name