Island Club Membership Cancellation Form
Date
*
/
Month
/
Day
Year
Member Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State
Postal / Zip Code
What is your preferred method of contact?
*
Phone
Email
No preference
Which location did you purchase your membership at?
Please Select
Albany
Thomasville
Baytree (Valdosta)
Inner Perimeter (Valdosta)
How long have you used our facilities and equipment?
*
Less than 6 months
6 months to less than 1 year
1 year to less than 3 years
3 years to less than 5 years
5 years or longer
What is the reason for cancelling the membership?
*
No longer need it
It doesn't meet my needs
Found a better/cheaper alternative
Quality of equipment was less than expected
Customer service was less than expected
Other
How would you rate our services
*
Well below Average
Below Average
Average
Above Average
Well Above Average
Customer Service
Knowledge of Equipment and Products
Quality of Equipment
Understanding Customer Needs
Sales Staff
Pricing
Cleanliness
Responsiveness
Friendliness
I understand that in accordance with the agreement I signed when I joined the Envy Island Tan, Inc membership club, I will be billed for 1 additional month if the date and time stamp on this request is not completed and received by midnight on the 20th of the month.
*
Yes, I understand
No, I do not understand
We understand that you wish to cancel your membership?
*
Yes, Cancel my membership
No, Please contact me
Member Signature
*
Questions or Comments
Submit
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