Refund Request

To be used to request refunds for University Recreation programs and services.

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Date*
MM slash DD slash YYYY
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
What is the program, membership, service, that you are requesting a refund for?*
Reason for Refund*
The amount of refund will be determined by the University Recreation Business Office. A $100.00 service fee may be assessed for processing refunds. If payment was made by credit card, a refund may be issued to the individual’s credit card. Refund checks will be mailed to individual’s at the above address. Please allow up to 4 weeks for receipt of refund check, if approved.
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