Cancellation of (family) membership -

Would you like to cancel your membership? Fill in the form below. Cancel a few points of attention / conditions:
-The (family) membership ends on December 31 of the current year.
-If you have a reading account, this will also end on December 31 of the current year.
-The cancellation must be submitted at least 1 month before the end of the current year. If the cancellation is submitted too late to DPHCN, the membership will continue until the end of the following year, including contribution payment for that year.
-If there is an outstanding contribution, it will remain due, even after 31 December of the current year.
-No refunds on amounts already paid.
-If the contribution has been paid by direct debit, the authorization will end on the date of cancellation, unless the cancellation has been received too late by DPHCN. In that case, the authorization is terminated at the end of the year following the year of cancellation.
-When canceling the membership, the family membership is also always terminated.
-It is also possible to cancel the family membership.

Date of cancellation: 14/06/2021
Which membership do you want to cancel? translations*
Your Name*

First name, Initials, Surname
Name Family Member*

First name, Initials, Surname
Address*
Street Address City ZIP / Postal Code Country
E-mail Address*
Phone Number*
Please only tick if applicable.
- My contribution / Dogs Global account was automatically debited
Please only tick if applicable.
IBAN bank account*
Reden opzegging
Statement of agreement*
- I agree to the cancel conditions as mentioned in this form.