Account Cancellation / Suspension Form

I, ______________________________ wish to do the following:

" Cancel my account with ColoradoNet / VailNet on _________________________

" Suspend my account with ColoradoNet / VailNet as of ______________________

My username is ___________________ and my password is __________________

Phone number where we can contact you if we have questions: ________________

Signature: ______________________________ Date: _______________________
* Signature is required to process this form.

If you are canceling your account with us, could you please provide a brief explanation as to why (This is optional).

OFFICE USE ONLY