CollegeofDuPage
ContinuingEducation
630‐942‐2208
ParentRefundFormforYouthAcademyStudents
Appliestostudentsunder18yearsofage
AllcreditbalancerefundsforContinuingEducationcourses(includingcoursecancellations,studentdrops,etc.)areissued
inthenameofthestudentassociatedwiththeenrolledcourse.Ifthepaymentwasmadebycreditcardandthecredit
balancerefundisissuedwithin60daysofpayment,therefundwillbeprocessedbacktothecreditcard.Iftherefundis
issuedmorethan60daysfromthepaymentdate,therefundwillbeissuedviacheckandwillbeissuedinthestudent’s
name.Inordertopickupthecheck,thestudentwillneedtopresenttwoformsofID.Iftheparentispickingupthecheck
onthestudentsbehalf,theparentmustpresenttwoformsofID,aswellasproofofpayment(creditcardusedtopayfor
thecourseorthereceiptassociatedwiththepayment).Intheeventthelastnameoftheparentorguardiandoesnot
matchthelastnameofthestudent,supplementalidentificationmayberequiredpriortothecheckbeingdistributed.If
thecheckisnotpickeduportheidentityofthepersonpickingupthecheckcannotbedetermined,thecheckwillbe
mailedtotheaddressonfile.
Tohavethecheckissuedintheparent’snameandtoensuretimelyandaccurateprocessingofcreditbalancerefunds,
thisformmustbecompletednolaterthanoneweekafterthepaymentismadeforthecourse.
StudentInformation
 
StudentLastNameStudentFirstNameMiddleInitial
  
StudentDateofBirthStudentIDTermAttending
ParentInformation
 
LastName FirstName MiddleInitial
  
DateofBirth SocialSecurityNumber
PermanentAddress–Street,City,State,ZipCode

   
PhoneNumber EmailAddress RelationshiptoStudent
IfyouDONOTauthorizetherefundtobeissuedbacktothecreditcardorstudentaccount,pleasecheckthisbox.

ParentSignatureDate
Pleasesubmittheformto:
CollegeofDuPage,ContinuingEducation–SRC1110
425FawellBlvd.,GlenEllyn,IL60137
FAX(630)942‐3785