JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Membership on hold Application Form 休会申請書
<Operation Rules for Membership on hold, Withdrawal, Reinstatement, and Re-enrollment of Membership>
https://drive.google.com/file/d/1Od71NDPHAjVBOgPpqWKnQ4DwaflzR29V/view?usp=sharing
<休退会等運用規定>
https://drive.google.com/file/d/1lynmZ_rjxZ9hux1S98xOXB9u2BL3ostj/view?usp=sharing
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Acceptance of the terms of this policy ご利用規約の確認
Please acknowledge your acceptance of the terms of this policy by ticking the box below.
上記 <退会・休会・復会・再入会規約> にご了承いただければ、チェックボックスにチェックをお入れください。
*
I have read the terms of this policy and agree to its terms. 規約を確認し了承致しました。
Required
Short-term membership on hold / Long-term membership on hold
*
Short-term membership on hold( 2~3 months)短期休会
Long Term Membership on hold( Periods from 4 months up to 2 years)長期休会
Child's name(s) / お子様のお名前
*
Your answer
Name of Parent or Guardian 保護者氏名
*
Your answer
Year of membership on hold ※Multiple registration possible 休会希望年 (年をまたいで休会される方は2022年2023年両方にチェックを入れてください)
*
2024
2025
Required
Membership fees when your membership is put on hold 休会申請に伴う会費引き落としの停止について
毎月21日までに受付されたお届けにつき、翌月分以降の会費引き落としを一時停止させて頂きます。
期限を過ぎて提出された申請書につきましては、翌月処理となり翌々月分以降の会費引き落としを一時停止させて頂きますのでご留意ください。
You can check multiple month(s) during which you wish to take break. 休会される全ての月にチェックをお願いします。
*
January 1月
February 2月
March 3月
April 4月
May 5月
June 6月
July 7月
August 8月
September 9月
October 10月
November 11月
December 12月
Required
Future email subscriptions 今後のメール配信
*
Request to continue receiving all emails 全てのメール配信の継続を希望
Request to continue to receive information about special events only 特別イベント案内のみ配信継続希望
Request to unsubscribe from all emails 全てのメール配信の停止を希望
Reason for Membership on hold 休会理由
Your answer
Any inquiries お問い合わせ
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms