Request for termination of membership

INSTRUCTIONS:

To permanently terminate your membership with Genium360, please fill in and sign the notice below.

WRITTEN NOTICE:

I hereby terminate my membership in the Corporation de services Genium360 in accordance with its bylaws (in French).

The contract shall terminate upon receipt of this notice at the Corporation's head office.

I understand that by ceasing to be a member of Genium360, I will no longer be able to participate in the life of the association, including voting in elections, serving on the Board of Directors or attending General Meetings.

Furthermore, I will cease to enjoy all the benefits (bank, insurance) available through Genium360 and I will no longer be eligible for them.

Genium360 membership number

This number can be found in your online profile

Postal code or country

Email address

Phone number

Why do you wish to terminate your membership?

Please specify

If I change my mind, I will have to reapply for membership.

Family name, Given name

I have read this form and understand all the information contained therein, and I confirm that all information submitted is correct and complete.