Cancellation form template

About this cancellation form

A cancellation form records a request to end a membership, subscription, booking, contract or order. Having it in writing protects both sides: the customer has proof they cancelled on a date, and the business has the details to process it and any refund correctly.

The template asks what is being cancelled, the reference number, when the cancellation should take effect, the reason (useful feedback for you) and refund details, with a confirmation section for the business.

What’s on the cancellation form

The template has 5 sections and 17 questions. Every one can be renamed, moved or deleted.

• Your details: Full name; Phone; Email; Address
• What you are cancelling: Type (choose one: Membership, Subscription, Booking, Order, Contract, Other); Name of plan, booking or product; Account, booking or order number; Cancel from (effective date); Reason for cancelling (optional) (choose one: Too expensive, Not using it enough, Moving away, Not satisfied, Found an alternative, Other); Comments
• Refund (if applicable): Refund to (choose one: Original payment method, Bank account, Store credit); Bank or account details (if different)
• Signature: Agreement: “I request the cancellation described above.”; Signature with date
• For office use: Processed by; Processed on; Final amount or refund

Tips

• Customers: keep a copy and note how and when you sent the form.
• Businesses: confirm every cancellation in writing with the final charge or refund amount.
• The reason question is optional; never make cancelling harder than signing up.

Four ways to save it

A fillable PDF has typing boxes, tick boxes and choices built in. A printable PDF gives clean boxes and writing lines for pen and paper. The Word file can be edited further, and the HTML code adds the same questions to a website. Browse more form templates, or design a completely different layout in the custom form builder.