Membership Modification Form
Member's Full Name *
Your answer
Today's Date *
MM
/
DD
/
YYYY
PLEASE READ
I wish to modify my membership with Oriental Phoenix Arts (OPA). I understand this form must be received 10 days before my next scheduled membership autopay date for this modification to be effective.
I have read and understand the statement above *
Required
Your Membership Autopay Date *
I wish to upgrade/downgrade to... *
Required
"Current" Membership End Date: *
This is the date you want your "Current" membership to end. It must end on the last day of the membership month of your current membership, for example on the 01/31/20XX or 02/14/20XX.
MM
/
DD
/
YYYY
New Membership Begin Date: *
This is the date you want your "New" membership to begin. It may be on the 1st or 15th day of the current or following month. If you also wish to change your monthly autopay date. There may be a gap between the Current and New membership. The amount of the gap will be prorated from the current "end date" to the new "begin" date.
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms