Membership Payment Report

*Payment Confirmation number

E-transfer: Your unique transaction ID number provided by Interac E-Transfer.

PayPal: Your unique transaction ID number provided by PayPal.

Plimus: Your unique Plimus payment reference number.

Google Checkout: Your Google order number provided by Google.

Graph card: Transaction ID number provided by Graph Card.

Western union: MTCN number provided by Western Union.

MoneyGram: Your reference number provided by MoneyGram.

Bank draft: Bank draft number.

Money Order: Money order number.

Certified Check: Certified check number.

Bank to Bank: Wire transfer transaction number provided by your bank.

Applicant's Information

Applicant's Full Name*

Applicant's Email*
Applicant's Phone number*
Applicant's Reference # or Email*

Payment Information

Payment Method
Payment Confirmation Number*

Payment date*

Amount of Payment*
Sender's Name*

Sender's City*
Sender's Province*
Sender's Country*
Sender's Phone Number
Sender's Email

Reciever's Name*

Reciever's City*
Reciever's Province*
Reciever's Country*

Secret Question (if any)
Secret Answer (if any)
Upload payment receipt

Note or Special instructions

*****IMPORTANT NOTICE*****
PLEASE VERIFY THAT ALL THE INFORMATION THAT YOU SUBMIT TO US IS VALID AND ACCURATE
REPORTING ANY MISLEADING INFORMATION WILL CAUSE YOUR ACCOUNT TO BE TERMINATED

CIFA

CANADA GREEN CARD

Membership Payment Report

Applicant's Information

Payment Information