IFFR Events at Montreal Rotary Convention &
Montreal Fly-Away
On Line Deposit
 (fill in the form below and click submit)

Use this form to submit your deposit. 

Member info:
Name:
Email: 
 

Attendees:
1. Name
2. Name
3. Name
4. Name

Payment:
A deposit of $500 per person commitment is authorized as follows:

Card number (Visa or MC):   
Expiration date: 
Code:
Cardholder name:
Authorized by:    
Amount authorized Canadian Dollars:

This charge on your credit card will appear on your statement as: "Cobourg Rotary Club"
If you prefer to transmit by fax, please print this page, fill in, and fax to Dean Pepper 1-905-372-9126.