Freeze Form

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Freeze Form

THIS FORM IS TO FREEZE YOUR MEMBERSHIP WHICH CANNOT BE DONE RETROACTIVELY.

Email *

What is your first name? *

What is your last name? *

Please list the first and last names of the person(s) who are being frozen. *

What is your scan card number?(this is not your Credit Card number)

If you do not know your scan card number, please leave blank.

What is your birth date(MM/DD/YYYY)? *

What is your phone number? *

What type of membership do you have? *

I have a EFT Membership (You pay a monthly bill)

I have a Prepaid Membership (Your membership is paid in full)

Would you like an email to confirm freezing? If so, you should receive the email within 24-72 hours of submitting this form. (Check spam folders if not seen.) *

Yes

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