Withdrawal Form

The Music Connection Withdrawal Form

Withdrawing from lessons will stop any future payments in accordance with the withdrawal procedures set forth in our policies. 

A minimum of 2-weeks notice from the date of this withdraw form  is required.   Please complete the Withdrawal Form below.  No monetary refunds will be granted except in the case of teacher cancelations.  If any pre-paid lessons remaining after the 2-weeks they will be saved as a credit for up to 6 months. (May be transferred).  Automatic payments will be discontinued after any unpaid balances are met.  Upon returning, you will not be charged a Registration Fee.

We thank you for allowing us to part of your music education and hope you or someone in your family will return again for more lessons in the future.   We hope you recommend us to a friend.

  • Student Information

  • Withdrawal Information

  • 1 is the Lowest, 5 is the Highest
  • 1 is the Lowest, 5 is the Highest
  • This field is for validation purposes and should be left unchanged.

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