CE Class Cancellation

CE Class Cancellation
*Please submit this form if you want to cancel your enrollment for your specified CE Class. If you are not currently enrolled, please contact the front office at 661-324-0105.*

If you decide to cancel within 7 days before your designated class start date, you will not receive your $100.00 CE class deposit.
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
Please enter the email address you would like your confirmation email sent to. example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Last Four of Your Social Security #*
Please select the class that you wish to cancel:*
Signature*

Clear
Should be Empty: