Web/Internet Services Cancellation Form

Please complete the areas below to cancel one or all of your services with Interactive Villages. You will be contacted via email or phone at the information, which you indicate below, to verify your request and receive any refund if due. Type in "unknown" if you do not have an answer for any of the fields.

Full Name:*

E-mail Address:*

Domain (URL):

Contact Phone:*

360.555.1212		 Company Name:

User Name:

Account Number:*

*Indicates Required Fields
Comments:*
Please indicate below why you are canceling your services
with us and/or to send us any other relevant information.
 
 
Services:
Check all that you would like to cancel

Web Hosting
SiteXpress
Domain E-mail
E-mail Filtering

Domain Aliasing
SSL Certificate
All Services
Other Services (please explain below)

Cancellation Date:
Please indicate below the date on witch you would like these services canceled. Realize that this is the date that Interactive Villages will de-provision the services that you have requested to cancel on this form.

NOTE that all cancellations require 30-days advanced notice.

Cancellation Date:

 
By submitting this order I accept Interactive Villages Terms and Conditions, and I hereby authorize Interactive Villages to proceed with the requested modifications to my account.