Membership Change/Cancellation Form

SJCC Membership Change Form
Membership Account Holder Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
E-mail Address *
Phone Number *
Type *

Cell Home Work
To update your payment information on file, please login to (or create) your self-service account here. Click on your name on the left-hand sidebar and update your payment information under Payment Tab.

You may also contact Denise Ipock, Membership Coordinator, at DeniseI@sjcc.org or 206-829-2594 to update your payment information.
I would like to make the following change(s) to my membership *

Make changes to my membership Put my membership on hold Cancel my membership Change my membership to a philanthropic membership

Membership Holds

To put a membership on hold, we require a start date and an end date. If you are on a monthly billed contract, your hold will start at the end of your current month. Upon receipt of this form, we will charge a one-time $35 hold fee.*

*if you have been financially impacted by the COVID-19 pandemic, please note that in the question below and we will waive the hold fee.
Hold Start Date *

Month Day Year
Date
Hold End Date (can not be longer than 3 months) *

Month Day Year
Date
Reason for putting your membership on hold
Number of hold days
Membership holds cannot exceed three months. Please select a start and end date that falls within three months.
I would like to have the hold fee waived due the Covid-19 pandemic. *

Yes No

Cancellation
We require 30 days' notice to cancel your membership, which will start from the day we receive this form. We do not offer refunds for partial months. If you cancel your membership before your initial 12-month commitment, your monthly obligation continues.
We are sad to see you go! Please let us know why you are cancelling your membership. *

Health or medical reasons Moved out of area I am not using my membership Joined elsewhere My children have aged out of programs Too expensive Other
Do you have other feedback or comments to share?

By typing your name below, you authorize the Stroum Jewish Community Center to make changes to your membership account and charge any fees related to those changes as outlined in your membership agreement. All payments, including but not limited to those for membership change fees, are non-refundable. Please see the terms & conditions section of your membership agreement for further details. *
Signature
Thank you for your updates. You will be notified once we have processed changes. Please allow 5 business days for changes to be made. If you have any questions, please contact Denise Ipock, Membership Coordinator, at DeniseI@sjcc.org or 206-829-2994.
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Membership Changes