Continuing Education Class Refund/Transfer Appeal Form

Continuing Education Class Refund/Transfer Appeal Form
This form may be used to appeal a transfer or cancellation once the refund policy deadline has passed. Requests made at least two business days prior should be directed to our office at 319-398-1022. For more information on Kirkwood Continuing Education's Refund policy, click here.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Class Name
Class Start Date

MonthDayYear
Reason you were not able to attend

0/0
Should be Empty: