Membership Cancellation Request

Full Name *

First Name

Last Name

Student Name

if different from your name

First Name

Last Name

When would you like your membership to end? *

Important timing: Please notify us no later than 1 week before the next billing cycle (2nd of the month) to avoid being charged for the following month. Any cancellations made after the 2nd of the month will take effect the following month.

At the end of this month

At the end of next month

Instrument Type *

Guitar

Piano

Drums

Jr Ninjas

Other

Location *

Burbank

Glendale

Santa Clarita

Orange

Why are your cancelling? *

Select all that apply

Scheduling conflicts

Financial reasons

Lost interest

Found an alternative program

Not progressing

Issues with instruction/style

Other

Would you consider rejoining in the future? *

Definitely

Unsure

No