Please fill in the details below and submit the form if you wish to cancel your place on a CPD module or programme running from 4th August 2020 to 31st July 2021. All the information you need to complete this form can be found in the email you will have received confirming your place, or your invitation to enrol email. 1. Full name (required) 2. Student number (required) 3 Your email (required) 4. Module or programme title 5. Module number or programme course code (if known) 6. Start date 7. Were you due to study a CPD programme or stand alone module? CPD programmeStand alone module 8a. Please advise us why you do not wish to study this particular module / programme Personal reasonsFinancial reasonsMedical reasonsWork commitmentsOther 8b. If you selected other, please specify Thank you for submitting your cancellation request. Your records will be updated accordingly. Please note that if you have been given PQ funding this will also be cancelled, and your employer notified. A copy of this form will be sent to the email address entered above. We are committed to ensuring compliance with current data protection legislation. We confirm that all data collected is used fairly, stored safely and is not disclosed to any other person unlawfully. Edge Hill is a data controller and, in some instances, may process this data. Information about how we use your personal data can be found at www.edgehill.ac.uk/ig/dpa.