Individual Membership RenewalRenewal Form & Payment Name* First Last Invoice #*Invoice Amount* Mailing Address* Street Address City Postal Code Province or Territory*Select from dropdown listNewfoundland & LabradrNova ScotiaNew BrunswickPrince Edward IslandQuebecOntarioManitobaSaskatchewanAlbertaBritish CoumbiaNorthwest TerritoriesNunavutYukonEmail Address* Payment Options:*Pay online now with Credit CardPay by eTransferCredit Card*American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Expiration Date Security Code Cardholder Name Pay by eTransfer: Please email your payment to: national@ipmaigp.caPhoneThis field is for validation purposes and should be left unchanged.
