MODEL WITHDRAWAL / CANCELLATION FORM
To:
Modero Club
hello@moderoclub.com
[FULL RETURN ADDRESS]
I hereby give notice that I withdraw from my contract of sale for the following goods:
Order number: __________________
Product(s): __________________
Date ordered: __________________
Date received: __________________
Customer name: __________________
Customer address: __________________
Customer signature (only if this form is notified on paper):
Date: __________________