mirahost
3420 e. presidio. rd. ste: two
Tucson, AZ 85716
http://www.mirahost.com
Voice: 800.253.0727   FAX: 815.642.0689
Or Scan and email to: cancellations@mirahost.com

"Standard" Hosting Service Cancellation Form
Must be completed by account owner.

Domains to cancel: ___________________________________________________________________________
Full Name: ___________________________________________________________________________
Company: ___________________________________________________________________________
Title: ___________________________________________________________________________
Phone number: ___________________________________________________________________________
Best time to call: ___________________________________________________________________________

Cancellation Survey
(optional feedback)

Please explain your reason for cancellation:

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

 

Please rate the following aspects of your service:   excellent acceptable barely acceptable horrible
           
Friendliness (sales staff)  
Technical ability (sales staff)  
Friendliness (support staff)  
Technical ability (support staff)  
Time to resolve issues  
Price of service  
Speed of network  
Control panel ease of use  
Appearance of website  
Domain transfer process  

 

 

Please answer the following simple questions: YES NO
     
I am transferring to another host provider...
I plan on hosting my site "internally"...
I am canceling service because of price...
I am canceling service because of lack of features...
I am canceling service because of a "downtime" issue...
I am canceling service because I am "out of business"...
I am canceling service because of a domain transfer issue...
I am canceling service because of an email issue...
I would recommend mirahost to other people...

 

I had the following number of hosts before mirahost: _________________________
I am switching to the following hosting provider: _________________________

I understand that upon receipt of this cancellation notice my account will be deactivated and I will not be billed for any future services. I am responsible for all previous charges incurred before my notice of cancellation. 

SIGNATURE: ______________________________________________________ DATE: ____________________