YMCA of Central Kentucky

Membership Cancellation

Member First Name
Member Last Name
Birth Date
Please indicate your home branch
 C.M. Gatton Beaumont YMCA
 High Street YMCA
 North Lexington Family YMCA
 Whitaker Family YMCA
Please indicate your reason for termination
 Monetary Concern
 Dissatisfaction with Service/Facility/Program/Staff
 Medical Concern
 Membership Experience
Can you explain your reason for termination in more detail?
How likely are you to rejoin the YMCA?
 Definitely Rejoin
 Probably Rejoin
 Probably Not Rejoin
 Definitely Not Rejoin
How likely are you to recommend the YMCA to friends or family
 Extremely Likely
 Somewhat Likely
 Not Likely At All
What did you like most about your YMCA experience?
What would you change about your YMCA experience?
Were you able to make a personal connection with YMCA staff or other participants?
Did you have a staff person or another YMCA member helping you with your fitness goals?

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