Da Ke American Chinese Culture Center

Withdraw Form

Da Ke American Chinese Culture Center want to ensure your satifaction of our services.  In any case that you are dis-satified, please allow us to address your issue.  Please do not hesitate to contact us at:

3379 Hwy 5, Suite AA
Douglasville, GA 30135
Tel: (678) 462-1197
Fax: (678) 391-8567
Email: info@dakeuschina.org

If you choose to withdraw from current class, please complete the fields below and we will respond to your request within 48 hours.  Full refund will be issued if withdraw request submitted within first 30 days of services.  1/2 refund will be issued if withdraw request submitted between 30  to 45 days of services. No refund will be issued if withdraw request submitted after 45 days of services.

Quarter Withdraw From:
Class Withdraw From: *
Withdraw Date:
First Name: *
Last Name: *
Student ID: *
Daytime Phone: *
Email: *
Withdraw Reasons: *

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