Required fields are marked with asterisks (*)

eBilling Registration Form

The Corporation of the Town of Pelham
20 Pelham Town Square. Fonthill, ON L0S 1E0 Tel. (905) 892-2607 Fax (905) 892-5055

Town of Pelham is committed to protecting your privacy and developing technology that gives you the most powerful and safe online experience. For full details of the Town of Pelham Privacy Policy please visit www.pelham.ca

First Name

Last Name

Address:

City

Province

Postal Code

Phone Number

E-mail Address

Property Location (If Different than previous)

Utility Bill Account Number

I/We authorize the Town of Pelham to register the bi-monthly Utility Billing for e-billing services

Yes

I/We agree to receive e-mail alerts.

Yes

Forms

eBilling Registration Form