Independent Contractor Payment Form

If you completed a project for SR Media Canada as an independent contractor, you can use this form to be paid. Please note that payouts will only be paid to VALID independent contractors. Submissions will be verified.

Name *

First

Last

Email *

Confirm Email

Phone *

Project ID *

Amount Due *

How much do we owe you?

How would you like to receive your payment? *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

We need your address to mail you your cash/cheque.