Community School of Performing Arts Drop Request Form

Community School of Performing Arts Drop Request Form
Complete the form below if you intend to drop out of a class or private instruction. This form is ONLY for the Community School of Performing Arts, and it does not apply to any other unit within the Colburn School, including the Trudl Zipper Dance Institute.

Submission of this form does not guarantee a refund, credit, or cancellation of remaining payments.
Academic Year*
Semester(s)*
Student's Full Name*

First NameLast Name
Student's Date of Birth*

MonthDayYear
Parent/Guardian's Full Name (if student is a minor)

First NameLast Name
Primary Email Address on Account*
Primary Phone Number*

I am requesting to drop...*
Drop Classes
Name of class(es) that you are requesting to drop:*
Day/Time of the class(es) that you are requesting to drop:
Name of instructor(s):*
Drop Private Lessons
What instrument is the student studying privately?*
Name of instructor:*
How many minutes are the student's lessons?*
How many lessons are you requesting to drop:*
Office Use Only
Classes
1) Course Name & ID
1) Instructor
1) Day/Time
1) Tuition
2) Course Name & ID
2) Instructor
2) Day/Time
2) Tuition
3) Course Name & ID
3) Instructor
3) Day/Time
3) Tuition
4) Course Name & ID
4) Instructor
4) Day/Time
4) Tuition
Lessons
1) Instrument
1) Private Instructor
1) Lesson Duration
1) Lessons Dropped
1) Tuition
2) Instrument
2) Private Instructor
2) Lesson Duration
2) Lessons Dropped
2) Tuition
3) Instrument
3) Private Instructor
3) Lesson Duration
3) Lessons Dropped
3) Tuition
Tuition Total
Amount Paid
Remaining Balance
Adjustment
Credit
Refund
Balance Due
Registrar Signature

Clear
Registrar Date

MonthDayYear
Date
Registrar Notes:

Invoice #
This can be found on your ASAP account or your tuition statements. Leave blank if you do not know the invoice #.
Are you currently on a payment plan?*

YesNo
Is the student currently a recipient of financial aid or scholarship?*

YesNo
Reason for drop (select one):*

Medical or family emergency (defined as an unplanned event that prevents participation). Documentation of medical or family emergency must be attached.Other reason. Please describe in the field below:
Explanation for drop:*
Upload documentation of medical or family emergency:

Cancelof

Drop/Withdraw Procedure

The drop request will be reviewed by the Program Manager and the Dean upon submission of this form. All refunds and credits must be approved by the Dean. There is no guarantee that a full refund and/or credit will be granted.

The student is eligible for a 100% refund of tuition if the form was submitted prior to the first day of the semester*. Following the start of the semester, students may be eligible for the following:

·       During the first week of class: refund up to 75%

·       During the second week of class: refund up to 50%

·       During the third week of class: refund up to 25%

·       Following the third week of class, there are NO REFUNDS

*NOTE: The first day of the semester for year-long enrollments corresponds to the beginning of the fall semester. The first day of the semester for single-semester classes (Early Childhood and Adult Classes) corresponds to the start date of the respective semester. Drop requests for year-long enrollments following the third week of the fall semester will only be honored pending the Dean’s approval. These terms also apply to private lessons.

Informing an instructor of a decision to withdraw, stopping payment, or not attending class does not constitute a withdrawal.

Exceptional requests for refunds due to a family or medical emergency may be made in writing to the Dean within 14 days of the missed class and must include appropriate documentation. There is no guarantee that a full refund will be approved due to a family or medical emergency.

Payments

Deferred payment plans will remain in effect until tuition is paid in full. Withdrawing from a class does not guarantee cancellation of remaining payments. Cancellation of remaining payments is subject to the Dean’s approval.

This is an abbreviated summary of our Registration and Academic Policies. For a complete listing of the Colburn School Policies, please refer to the Student Resources page.
Signature*

Clear
By signing this form, I agree to abide by the school policies as published on the Colburn School website at www.colburnschool.edu/community-school/student-resources/, and I acknowledge that I have read the abbreviated policies above.
Should be Empty:

Community School of Performing Arts Drop Request Form

Drop Classes

Drop Private Lessons

Office Use Only

Classes

Lessons