Modo Yoga LA Membership Hold Request
Be Awesome members can request an unlimited number of holds on their membership. Holds must be for a minimum of 30 days and a maximum of 90 days. There is also a $30 fee for each membership hold requested. Please provide the following information to request a membership hold. You will a receive a confirmation email upon processing. (NOTE: Completing this form will not automatically hold your membership, but submits your request for processing.)
MEMBER FIRST NAME *
Your answer
MEMBER LAST NAME *
Your answer
MEMBER PHONE NUMBER *
Your answer
MEMBER EMAIL ADDRESS *
Your answer
HOLD START DATE *
MM
/
DD
/
YYYY
HOLD END DATE *
MM
/
DD
/
YYYY
REASON FOR HOLD REQUEST *
Your answer
*
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service