Model withdrawal form
Complete and return this form only if you wish to withdraw from the agreement. Using it is optional — any clear statement is enough. Send it by email to [email protected], by post, or hand it in at the salon.
To:
Barbara Jerzykiewicz-Młynarska — Glomani
ul. Stefana Starzyńskiego 2, 35-508 Rzeszów, Poland
[email protected]
I/We(*) hereby give notice that I/we(*) withdraw from my/our(*) agreement for the provision of the following service / for the purchase of a gift voucher(*):
Date of visit or voucher number
Service or voucher I am withdrawing from
Date the agreement was concluded (booking / voucher purchase)
Full name
Address
Phone or email
Account number for the refund (only if you paid by bank transfer)
Date
Signature (paper version only)
(*) Delete as appropriate.
We will confirm receipt by email or text message and refund the money within 14 days using the same payment method. See Right of withdrawal.