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退会フォーム
小規模保険外サービス事業者団体の『退会』フォームです。
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* Indicates required question
Email
*
Your email
退会年月日
*
MM
/
DD
/
YYYY
代表者名／事業者名
*
Your answer
会員No
Your answer
退会理由
*
廃業
休業
金銭的な問題
団体加入の意義を感じなかった
Other:
Required
退会にあたって
退会の手続き
を確認しましたか？
*
はい
いいえ
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