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Notice of Withdrawal

EVSM Contract 30-Day Notice of Withdrawal Policy

East Valley School of Music requires a 30-day notice of withdrawal from lessons at any time. To withdraw, please inform your instructor and fill out a Notice of Withdrawal Form to turn in to the front office. If a student is unable to finish out the 30 days, the remaining lessons must be paid for in full.
By signing this form, you are notifying East Valley School of Music of your intent to withdraw
from lessons.

I, , have reviewed the terms of this agreement and wish to withdraw from lessons at East Valley School of Music.

Instructor:

Reason(s) for Withdrawal:

Date of final lesson: Date final invoice was sent:

Talked to: Date:

Method of Contact: __In Person __By Phone __By Email
Procedures (initial after complete):

___ Notified instructor ___ Recurring Invoices/Billing
___ Master Database ___ Instructor Pay
___ Teaching Schedule ___ Form Scanned
___ Teachworks ___ Confirmation Email
___ Adjust final invoice ___ Manager’s Initials

I understand that by signing below I am withdrawing, from lessons at East Valley School of Music in accordance with EVSM Withdraw Policy outlined in the Client Contract signed upon enrollment.

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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Timestamp

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June 29, 2022 9:20 am MST

Notice of Withdrawal Uploaded by Mike Kaminski - office@evsm.net IP 174.74.154.56