JSTV+1 (プラスワン)解約通知書

This is the cancellation form for the JSTV+1 customer whom wants to cancel the internet viewing only.
Please send the satellite cancellation form if you wish to cancel your satellite subscription as well.
お名前/Name *
Mr.   Mrs.   Ms.  その他 other
姓/Surname  名/Forename
JSTV会員番号 / JSTV No. *
Email address *
Daytime Phone *
解約希望月 /
Month of Cancellation *
I hereby cancel my JSTV+1 internet membership as of end of the month:
Year/ Month/
解約理由 /
Reason for cancellation *
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