Canadian Payment form

To ensure the security of your personal information you have been taken to a secure form on a secure server hosted by our payment provider - Paypaq™ Solutions Inc. Paypaq™ Solutions Inc. is a validated Service Provider under Payment Card Industry Data Security Standards (PCI) (www.paypaq.com). Look for the locked lock on your browser's status bar or https: to ensure you are submitting your payment information on a secure form.

Company:

First Name:

Last Name:

Address:

City:

Province/State:

Postal/Zip Code:

Country:

Telephone:

E-Mail:

Invoice #:

Amount: $ CDN

Comments:

Leave Blank:

Credit Card Information

Card Type:

Card Number:

CVV: What is this?

Expiry Date:

Cardholder Name:

Note: When making your payment securely online it is very important to hit the Submit button once only and wait for the authorization receipt to come up on the screen. If you hit the submit button twice or hit stop and re-submit you run the risk of having your credit card authorized twice for your one payment. The system works quickly and you will have an authorized receipt on your screen within 10 to 60 seconds depending on bandwidth. If any problem occurs please e-mail us immediately.

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