Student Refund Request Form "*" indicates required fields Name* First Last CPA ID:* Email* Program:Please selectPEPPREPPREP Course Name:Please selectIntroductory Financial AccountingIntroductory Management AccountingEconomicsStatisticsIntermediate Financial Reporting IIntermediate Financial Reporting IIAdvanced Financial ReportingCorporate FinanceAudit and AssuranceTaxationIntermediate Management AccountingPerformance ManagementBusiness LawInformation TechnologyPEP Course Name:Please selectCore 1Core 2Elective – FinanceElective – AssuranceElective – Performance ManagementElective – TaxationCapstone 1Capstone 2Common Final ExaminationReason for the Refund:Please selectMedicalWork (change jobs, not required for job)Family committmentsTransfer outNo longer interested in pursuing designationNot satisfied with the programIf you are not satisfied, why?Comments (Optional):Refund Request Payable To: Student (Complete Part A) Organization (Complete Part B) PART ASelect Preferred Method of Payment Electronic Fund Transfer E-mail Money Transfer Electronic Fund Transfer InformationBank # Transit # Account # E-Mail Money Transfer InformationEmail PART BOrganization Name Contact Name Contact E-Mail Address PhoneThis field is for validation purposes and should be left unchanged.