Request for a Preauthorized
Recurring Debits Form
Please download the appropriate form. Print it, fill it
out and return it to us by mail or by fax at
If you choose the preauthorized bank debit mode of payment,
please attach a Cancelled cheque.
a form by mail or for further information, you can contact
us at 514.274.9446 or e-mail us at email@example.com