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Refund Request Form

This form must be completed for all refunds. It takes approximately 10 to 14 business days to process a refund. It may take longer before the credit appears on the patron's credit card statement. *Category "7" requires an explanation. You must fill out fields before submitting this form!

This refund is subject to a $5 service fee.

Reason Requirement Adjustment Service Charge
1-Illness Doctor's note May be pro-rated No
2-Moved out of Arlington Heights New address May be pro-rated No
3-Schedule conflict w/AHPD programs Refund form May be pro-rated No
4-Schedule conflict - general Refund form May be pro-rated Yes
5-Class status change (closed, cancelled, transferred) Refund form None No
6-Satisfaction guarantee Refund form None No
7-Other (*explanation) Refund form May be Pro-Rated Yes

 

    Indicates required field
Participant's Name     
Program Title     
Program ID Code     
Program Start Date     
Contact Name     
Phone     
Email     
Reason for Refund     
Other Explanation     
Note: If original form of payment changes, refund will be made in check form.   
Please make refund payable to:     

 
 
 
Arlington Heights Park District
410 N. Arlington Heights Road
Arlington Heights, IL 60004
Phone: 847-577-3000
Fax: 847-506-2735
 
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