MOSBY WOODS POOL - DEFERRAL/CANCELLATION FORM
Use this form if you would like to cancel or defer your membership and to give us feedback on your overall pool experience
Member Last Name(s)
Member ID Number
Found in the box on the right hand side of your renewal form. If not sure, give street address.
****If you will be suspending your membership, please send a $30 check, payable to "MWRA" to 3136 Plantation Pkwy, Fairfax, VA 22030
If you are suspending your account, when do you expect to return?
Not Sure; Will advise
If joining another pool, which one?
Reason(s) for Cancellation/Suspension
Please tell us the reason for cancelling/suspending. Check all that apply.
relationship(s) with member(s) of other pool
amenities ( tennis, golf, etc)
temporary job transfer
We welcome any comments you have about your experience at Mosby Woods Pool and suggestions for improvement..
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