RaiderCard

Refund Request Form

A cardholder who wishes to receive a refund check must make a formal request using this form. The following conditions must be met for the refund request to be considered:

The account holder graduates, withdraws, or is dismissed from GRCC
The account balance is $5.00 or more

Refund checks will be written in the name of the account holder and will be mailed within 15 business days after a valid request is received.

If you have any questions, please email us at raidercard@grcc.edu.

* required fields.

Personal Information

First Name: *
Last Name: *
Student ID: *
Phone: *
Email: *

Mailing Address

Address: *
City: *
State: *
Zip: *

Reason for Refund

Please go into any additional detail regarding your refund request *

Refund Amount

The account balance must be $5.00 or more for the request to be considered.

Account Balance

Confirmation

By submitting this form, I am stating that I agree to the terms and conditions of the refund program.

: I understand and agree to the terms and conditions

Updated on 02-JUL-08
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Refund Request Form