NCRWA Backflow Cross Connection Training Cancellation & Refund Request Form
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Email *
REQUESTER CONTACT INFORMATION (required)
All refunds and receipts will be sent to the person listed here.
First Name, Last Name
 *
Employer
 *
Street Address
 *
City, State, Zip
 *
Phone Number
*
Fax Number
BACKFLOW CROSS CONNECTION TRAINING CANCELLATION & REFUND
Backflow Cross Connection training class refund requests will be processed up to 5 business days prior to the class start date. No refunds will be given after this deadline. Refunds will be issued minus a $25.00 cancellation fee. Under certain circumstances with proper notification you may request to move to another class within 5 days of the class start date.

If you fail to notify your NCRWA Backflow Cross Connection instructor of your class absence within the 5 business day deadline and do not show up for your registered Backflow Cross Connection class, no refund will be given. Under certain circumstances if you do not show up for a class, you may request to move to another class, however a $50.00 re-seating fee will be charged in addition to the class price.

Please provide all information below in order to receive a refund:
Cancelling Registrant's Name
 *
Class Name
 *
Class Date
 *
MM
/
DD
/
YYYY
Class City
*
Reason for Refund Request
*
Refund check will be made out to the registrant’s employer listed on your registration.


(If you paid via credit card, we will refund your card unless more than 90 days have passed, then a check for your refund will be mailed.)
Total Fee Paid:
 *
- Cancellation Fee of $25
Total Refund:
*
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