1 Start 2 Complete Please fill out this form and submit it in order to cancel a registration. If a refund is owed to you, the staff at BU SHIELD will be in touch. Name of SHIELD Program for Refund * Date of SHIELD Program * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 Amount Paid * Please include your full name * Confirm or provide email address * Leave this field blank
