Music Showcase
402 Oakfield Drive
Brandon, FL 33511
Phone: 813-685-5998
Fax: 813-689-7528
Debracampos@musicshowcaseonline.com

 
Music Showcase - Cancellation Form
Attention: Do not use this form if you are cancelling the day of your lesson.
 

The date and time stamp for this cancellation request is 12/20/2014 at 6:28:07 AM.
 
Student's Name:    
 
Parent's Name:
 
Primary Contact Phone Number:
 
Secondary Contact Phone Number:  
 
Teacher's Name:
   
 
What date(s) are you cancelling?
(100 characters max.)

What time(s) are you cancelling?
(100 characters max.)

 
If you would like to schedule a make-up lesson?
Yes, please contact me so I can reschedule this lesson.  
No, I do not need to reschedule this lesson.
 
What is the reason for your cancellation or ending of lessons?
(250 characters max.)
 
Please confirm the following information:
I am cancelling a scheduled lesson(s), I'm NOT ending all my future lessons.
I am ending all future lessons.
 
Please note: You must pre-pay for the next lesson to secure your lesson time upon your return.


Your reference number for this cancellation is: 605178

Please print this form before you submit it and keep it for your records.

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