Cancellation Form

The form below must be completed in order for you to terminate your private lessons or withdraw from a group class at Opus11 School of Music. This form is valid for a single student taking a single class. If you are terminating lessons for more than one student (family member), please submit a seperate form for each student and instrument.

This form must be completed by the 15th day of any given month in order for a withdrawal to take effect at the end of that month. If the form is recevied on or after the 16th day of the month, your termination will be considered effective as of the end of the following month. For example, if this form is submitted on the 16th of March, your termination will be considered effective as of April 30. There are no exceptions.

When we receive your termination request, your teacher and time slot will be made available as of your termination effective date. You're welcome to withdraw your termination at any time, however your time slot and teacher can not be guaranteed.

This form may also be used for a temporary withdrawal during summer months (June - August) due to travel or other circumstances. 14 days advanced notice is required to put regularly scheduled private lessons on a summer hold.

ALL lesson credits WILL EXPIRE 90 days after disenrollment, including “non-expiring” credits issued by Opus11 School of Music. The new student enrollment fee will apply to any former students who wish to later return to Opus11 School of Music. No portion of any tuition payments made shall be refundable as a result of a request to terminate or under any other circumstance.

Today's Date

Date

Student

First NameLast Name

Adult Student?

Parent/Guardian

First NameLast Name

Email Address

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Teacher's Name

Instrument/Class

Withdrawal Type

Summer Hold are available during the months of June, July, and August only. Enrollment may be placed on hold for a maximum of two months, with a minimum of 14-day notice before the first day of the month where the hold is to take place. The latest resume date is September 1. Your scheduled teacher and lesson day and time will be held only with pre-payment of tuition for the returning month at the time of departure. While enrollment is on hold, students may purchase individual lessons during that time, but the hold may not be cancelled nor may its duration be modified once confirmed. Holds are not available at any other time during the year. If a student discontinues lessons without placing their enrollment on hold, the new student enrollment fee will apply when the student returns and will be subject to then-current schedule availability.

Cancellation/Withdrawal Reason

Date of Departure from Opus11

Date

Date of Return to Opus11

Date

Please describe your experience with your Teacher at Opus11

What was your favorite part of being a student/family of Opus11?

What could we do better at Opus11 School of Music?

Is there anything we could have done differently for you or your child?

Would you like a response to your feedback?

Parent/Guardian or Adult Student Signature