ICRI Event/Convention Cancellation Refund Form

Please complete the following form to request a refund of your ICRI event or convention fees.

"*" indicates required fields

Which event are you requesting a refund for?*

I have registered for the event as an:*

Attendee

Exhibitor/Sponsor

Name*

First Last

Email*

Phone (include area code)*

Company/Organization*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

I would like to be refunded by:*

Check

Credit Card (if this was the original payment option)

Please note that all refunds are less a $75 cancellation fee.

Additional Information

Please include any details regarding your refund request.

Checkbox*

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Name

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