Learning Gift Certificate Request Form

Give the gift of education! We are offering Learning Gift Certificates, perfect for giving to friends, loved ones or colleagues. Gift an amount of your choosing. Learning Gift Certificates can be applied to most Spring & Summer 2023 non-credit courses; please note that they cannot be used for motorcycle courses, credit-bearing classes or events such as Collaborative Cuisine dinners.

By submitting this form, the purchaser acknowledges that once the recipient has applied the certificate to their course(s), the purchaser will be billed for the cost of the course(s) up to the amount specifed on this form. SUNY Adirondack Continuing Education refund/drop/tuition liability policies apply, as specified at sunyacc.edu/continuing-ed/registration. You will be invoiced at the address provided on this form once your recipient registers for a class that is scheduled to run.

Please note:

Learning Certificates require recipients to register for a course with SUNY Adirondack Continuing Education before they can attend.
Courses are subject to change, so if the course(s) specified on this form are filled or cancelled, the dollar amount you indicate on this form may also be applied to another course of the recipient's choosing.

The certificate is valid through Aug. 31, 2023. Certificates will be forfeited if not used.

Recipient's Legal Name

First Name Last Name

Recipient's Preferred First Name (optional)

Student ID/Banner ID (if applicable)

Recipient's Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Recipient's Email Address

example@example.com

Recipient's Phone Number

Please enter a valid phone number.

Please select the option below.

This certificate is for a specific dollar amount so the recipient can choose which course(s) to take.

Please specify the dollar amount of this certificate.

For each course, please specify the title, CRN and dollar amount for which you are purchasing this Learning certificate. Courses are subject to change, so if the course(s) specified on this form are filled or cancelled, the dollar amount you indicate on this form may also be applied to another course of the recipient's choosing.

	Course Title	CRN	Dollar Amount
Course 1
Course 2
Course 3

Please select your preferred delivery method.

Learning Gift Certificate Request Form

GIFT RECIPIENT INFORMATION

PURCHASER INFORMATION