Date of Request* Person requesting cancellation* First Name Last Name Company Name*Email* Company Phone*Company Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Please tick box for service/ s you would like to cancel and advise of domain / email / website / social media page* Domains Email SEO PPC Social Media Management / Advertising Hosting Services (CMS) Other Other*Website* Backups I would like you to take a backup of my website before I cancel/transfer to another provider for a fee of $60. Please state your main reason for cancelling this service/these services:*Cost / ValueIve engaged an alternative providerI know longer require this serviceI have had issues with this serviceWe are in-housing this servicePlease note, if you do not select this option, we will remove all versions of your website on our server. Please also note that if your new hosts/developers require support to handle the migration, we reserve the right to charge. I agree and understand the following The above listed parties are requesting the cancellation of the above services from The Creative Collective. We agree that the date received by The Creative Collective must be within 30 days of the next billing cycle and if this received date falls within the 30 day period the following month’s I may be billed. As of this date The Creative Collective is no longer responsible for the uptime or upkeep of the services listed above that I have selected. I, the client above is responsible for making other arrangements to move any of the below listed domains or emails to a third party location and any services such as data applications or websites that require configuration on a third party server is a billable service and The Creative Collective offers no warranty of any kind in assisting a client’s move to a third party. This iframe contains the logic required to handle Ajax powered Gravity Forms.