Summer Bridge 2021 Cancellation Request Form

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Please complete this form to cancel your Summer Bridge 2021 Enrollment.

The following fees apply:
• If you cancel by or before May 31, no cancellation fee will be assessed
• If you cancel between June 1 and June 14, a $200 cancellation fee will be assessed, regardless of reason
• If you cancel on after June 15, a $600 cancellation will be assessed, fee regardless of reason

No refunds will be given for withdrawal, dismissal, or leave of absence after the first day of Summer Bridge. In addition, you will be assessed a $600 cancellation charge regardless of reason as well as any housing, dining, textbook, summer sessions, and Class Pass fees incurred. You will be personally responsible for payment of these fees by August 23. Any financial aid received for summer may be canceled.

Today's Date *

YYYY

Your Name (as it appears in UCB records) *

(First, Middle, Last)

Your Student Identification Number (SID) *

Your Email Address *

Your Telephone Number *

Your Reason for Cancellation *

Submit

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