(If you wish to cancel the contract, please complete and return this form).

Lernstützpunkt Süd GmbH Schönleinstraße 2 70184 Stuttgart support@lernstuetzpunkt-sue.de

I/we (*) hereby revoke the contract concluded by me/us (*).

– Booked on (*)/ received on (*)

– Name of the consumer(s)

– Address of the consumer(s)

– Signature of the consumer(s) (only for notification on paper)

-Date

(*) Please delete as applicable.