MODEL WITHDRAWAL FORM

To: SPEAKINGO Nauka języka angielskiego dr Grzegorz Kuśnierz, ul. Stefana Czarnieckiego 5/106, 53-650 Wrocław, Poland; info@speakingo.com.

I hereby withdraw from the contract concerning:

Date of contract:

Account email or order number:

Consumer name:

Consumer address:

Date:

Signature (paper only):

Using this form is optional. Any clear statement of withdrawal is sufficient.