Membership Cancellation Form

Cancellation Form

Please note: Cancellation is effective 30 days from the date that this form is received.

We are truly sorry that you have decided not to continue your membership.
We would greatly appreciate your feedback on your personal experience at the Katz JCC. This survey will help us to understand how we can better serve our community. Please contact us if we can be of any assistance now or in the future. We hope that one day you will choose to rejoin the Katz Jewish Community Center.
Name*
First Last
Member #
Phone Number*
Email*
Effective Date of Cancellation*
Today's Date*
What are your reason(s) for discontinuing your membership?*
- Customer service
- Cost
- Facilities
- Children no longer in youth programming
- Hours of operation
- Joining another facility
- Moving out of town
- Illness
- Too far from home/work
- Utilize my home equipment
- Other
The Katz JCC does not offer:
Comments
What programs/services of the Katz JCC did you utilize?*
- Sari Isdaner Early Childhood Center
- After School Programs
- Babysitting
- Summer Day Camps
- Vacation Day Programs
- Life Long Learning Classes
- ACHaD
- Cultural Events
- Judaic Programming
- Fitness Center
- Aquatics
- Swim Lessons
- Group Excercise Classes
- Personal Trainers
- Sports Leagues-Adult
- Sports Leagues-Youth
I utilized another Program
Please Rank Us
Rank the following aspects of the Katz JCC. 1 being the least satisfying and 5 the highest and best rank.
Friendliness of Staff*
- 1
- 2
- 3
- 4
- 5
Program Quality*
- 1
- 2
- 3
- 4
- 5
Value of Membership*
- 1
- 2
- 3
- 4
- 5
Fitness Center*
- 1
- 2
- 3
- 4
- 5
Group Excercise Classes*
- 1
- 2
- 3
- 4
- 5
Aquatics*
- 1
- 2
- 3
- 4
- 5
Sports & Leagues*
- 1
- 2
- 3
- 4
- 5
Please let us know if there were other programs/services you utilized. How would you rank them?
Were there any programs or services you were looking for that we did not offer?
If such programs or services were offered in the future, would you consider rejoining?
- Yes
- No
- Undecided
Were you aware that the Katz JCC provides financial assistance? If no, would you be interested in someonecalling you about these options? (The scholarship process is confidential).
Do you have any additional suggestions on how the Katz JCC could better serve you and other members?