PAD Form – Intella Canada

Pre Authorized Debit Form

PAD Form

Pre-authorized Debit (PAD) Agreement

This donation is made on behalf of

An Individual

A Business

I would like to support

Intella Canada

International Tours

The debit will be processed to your account on the 15th day of each month or the next business day.

Please debit my bank account for the amount of:

I would like to submit my banking information by:

Uploading a Void Cheque

Enter my Banking Information

Please Upload a Void Cheque

Choose File

Banking Information

Please fill out the following:

Transit Number

Institution Number

Account Number

Branch Address

Address Line 1

Address Line 2

City

Province

Postal Code

Country

Donors Information

Please fill out the following information:

First Name

Last Name

Address

Address Line 1

Address Line 2

City

Province

Postal Code

Country

Home Phone

Work Phone

Mobile Phone

Pre Authorized Debit Form

Pre-authorized Debit (PAD) Agreement

Please Upload a Void Cheque

Banking Information

Donors Information

Support Intella Canada

Support International Tours

Pre Authorized Debit