Membership Cancellation Request Form

Membership Cancellation Request Form
Your Information

Please complete the form with your information
Your Name

First NameLast Name
Your Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Your Email (Your email used upon sign up at Altea)
example@example.com
Thank you for submitting your initial request to cancel your membership. As mentioned, cancellations must be completed in person or by registered mail as the change to your membership agreement requires a signature. As you will be out of the country, we can make a onetime exception to accept the cancellation of your Altea Active Membership with the completion of this form. Please include your electronic signature with the following details:

I {yourName} approve for my Altea Active membership to be cancelled as per the Altea Active cancellation policy.
Signature
Should be Empty:

Your Information