Withdrawal - Request to Withdraw form If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Your Info Your First Name * Your Last Name * Your Email Address * Street Name and Number * City * Province Alberta British Columbia Manitoba New Brunswick Nova Scotia Northwest Territories Nunavut Prince Edward Island Quebec Saskatchewan Yukon Newfoundland and Labrador Ontario Postal Code Your Telephone Number * Course Info The course I am registered in is * choose one Mortgage Agent Course CMIP Date you purchased the course (dd/mm/yyyy) - if you know Reason(s) for withdrawal - please check all that apply Other commitments (work, family, etc.) please provide details below)Ilness (please provide details below)Unhappy with instructor (please provide details below)Course changed and I was unable to attend new date/location Refund Amount (as per Terms and Conditions of Enrolment): Upon receipt the request will be processed based on the following schedule: After registration but before the examination AND within 30 days of registration: 100% refund MINUS a $150 withdrawal fee. During or after the examination or after 30 days after registration: No credit and No refund * Yes - I have read and understand the refund amount Details or Notes you would like us to have NOTE: once you click this button you will see a success page and an email confirmation will be sent. If you DO NOT see the page and receive a confirmation email your request has NOT been submitted. Please try again or call us directly.