Full name of payor
Student GWID
Amount of payment
By submitting this form, I acknowledge that my request has to be received by 1:30pm the day the payment was submitted in order for the cancellation request to be processed. Cancellations cannot be processed between 1:30pm and 3:00pm; payments submitted during this time cannot be cancelled. If the payment was made after 3:00pm, then the request must be received no later than 1:30pm the following business day. If the request is not received by that time, then it cannot be processed.