Cancelation/Refund Request Form

Name*

First Last

For what event are you requesting a refund?*

Registration Order Number*

Original Payment Method*

Debit/Credit
Check

Email*

Please provide the email address associated with your AIAS membership.

Phone*

Reason for Cancelation*

Cancelation Confirmation*

I understand that I am canceling my registration in its entirety and that I will be sent a refund minus the $10 processing fee (for FORUM and Grassroots items) as detailed on the registration site when I registered.

I agree

Comments

This field is for validation purposes and should be left unchanged.