Automatic Renewal Cancellation Form

Please use the form below to notify Servus Credit Union Place that you do not wish your annual monthly membership to automatically renew upon the renewal date.

This form/submission does not cancel your current membership contract and only prevents it from auto renewing.

Membership Information

Primary Contact: *

Home Phone: *

E-mail address: *

Mailing Address: *

City:

Postal Code: *

Family members to cancel - (include primary contact if applicable)

Name:

Type of membership:

Date of Birth:

Name:

Type of membership:

Date of Birth:

Name:

Type of membership:

Date of Birth:

Name:

Type of membership:

Date of Birth:

Name:

Type of membership:

Date of Birth:

Name:

Type of membership:

Date of Birth:

Reasons for cancellation

Reasons for cancellation:

If "Other" explain why:

I understand that this form/submission does not cancel my current annual membership contract and only prevents it from auto renewing.

For further information or if you have any questions, please contact Guest and Member Services at 780-418-6088 or email us at spquestions@st-albert.net

I have read the above and agree. *

A copy of this form will be e-mailed to you. Please retain it for your files. In the case that the primary contact (1st adult) wishes to cancel, all remaining members will be charged accordingly, meaning that the remaining adults will be moved up to 1st adult, and 2nd adult.Servus Credit Union Place's annual monthly memberships shall renew, automatically unless cancelled by the member at least 3 business days prior to the end of the membership term.