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English (US)
Freeze / Cancel Membership
Fill out this form to request a cancel or freeze your mActivity membership.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Purpose
*
Choose One
Freeze Membership
Cancel Membership
From Date (future date only)
*
-
Month
-
Day
Year
Freeze/Cancel will be executed the next business day.
To Date (future dates only)
*
-
Month
-
Day
Year
Date
Reason for Cancellation:
*
Choose One
Moving
No time
Medical
Financial
Not Happy
Lack of Use
Reason for request:
*
Submit
Should be Empty: