Refund Request

Students with balances in their accounts can use this form to request their refund check. Checks can be held for pick-up, or sent to either the students' permanent address.

Name:
Date of Birth:	(mm/dd/yyyy)
Student ID Number:
E-mail:
Amount requested:	Entire Balance Other Amount:
Send check to:	my permanent address hold for pick-up at the Accounting Office

Maintained by webmaster@wpi.edu
Last modified: Jan 22, 2007, 11:19 EST