IC PAD Restart - Payment - Innovate Calgary Member Portal

Last Name

First Name

I authorize UTI Limited Partnership, o/a Innovate Calgary, to debit my bank account with the amount due for my monthly membership fees and/or parking fees

Yes, I agree to the authorization

These services are for (check one)
Personal

Business

Fee:
Amount displayed includes GST

Financial Institution Number (3-digit)

Branch Transit Number (5-digit)

Account Number

Account Holder’s Name

Account Holder’s Signature (Type full name)

Date Signed

Notes (Pre-authorized debit description)

We use a third-party payment processor, Stripe, to handle your transaction securely, see Stripe’s policies here to learn more. We do not collect or store your Pre-Authorized Debit details or banking information.