Payment Plan Request Form
If unable to make full payment on a PFC invoice by due date, please submit the below form to request your invoice be placed on a payment plan.

Payment plans will be confirmed by PFC.

Submission of this form is an agreement to make payment of installments as described below. If your situation changes and you are unable to make payments as agreed, please reach out at secretary.pakenhamfloorball@gmail.com
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Email *
Your Name *
Invoice Number *
The reference number quoted on your PFC issued invoice (see below)
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Number of installments *
To be paid *
Expected date of first payment *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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