CreditDebit Card by gabyion

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									                                THE SPORTS INDUSTRIES FEDERATION LTD
                                     SUBSCRIPTION PAYMENT FORM

Credit/Debit Card
Credit/Debit Card please tick preferred type of card               Card Holder’s Address: ………………………………………..
 Visa  Access         MasterCard
                                                                   …………………………………………………………………....
I authorise you to debit my card account immediately
with the amount of £ ………………                                        ……………………………… Post Code………………………

Card No

Member’s Name:……………………………………………                                     Membership No: …………………………………………. ….

Start Date                     Expiry Date                           Issue No
(If applicable)

Cardholder’s Name: ………………………………… Signature: ………………………………… Date: ………………………..
________________________________________________________________________________________________

             Instruction to your Bank or Building Society to pay by Direct Debit
Please fill in the form and send to: The Sports Industries Federation, Federation House, NAC,
Stoneleigh Park, Warwickshire, CV8 2RF

Name and full postal address of your Bank or Building Society
To: The Manager                                                      Originator’s Identification Number:
                                      Bank/Building Society          7     6    8    1      3    3
Address:                                                             Reference Number:


                                                                     Instruction to your Bank or Building Society
                                                                     Please pay The Sports Industries Federation Direct Debits from
                         Post Code:                                  the account detailed in this Instruction subject to the safeguards
Name(s) of Account Holder(s)                                         assured by the Direct Debit Guarantee.
                                                                     I understand that this instruction may remain with The Sports
                                                                     Industries Federation and, if so, details will be passed
Branch Sort Code:                                                    electronically to my Bank / Building Society.

Bank/Building Society account number                                    Signature(s)

                                                                        Date:

             Banks and Building Societies may not accept Direct Debit instructions from some types of accounts

Standing Order                                                               Please Pay:
Name of your Bank                                                            The Sports Industries Federation
                                                                             National Westminster Bank
……………………………………………………………...Bank                                               PO Box 399
                                                                             40 Whitgift Centre
………………………………………………………… Address                                               Croydon
…………………………………………………………………...                                                 Surrey
                                                                             CR9 3QB
……………………………………………………….………….
………………………………Post Code………….……………
Account No:                                                                  Account No: 01110640

Sort Code:                                                                   Sort Code: 60-50-01

The sum of £        …………… Amount In Words……………………………………………………………………………………
……………………               instalments of ………………………………………………..                               from ………………………….. 20……
(The amount should be one tenth of the total subscription including VAT – payable over 10 months)
Your signature……………………………………………………………….
(as bank mandate)
Printed Name:   ……………………………………………………………..


Cheque                                                             I enclose a cheque, made payable to The Sports
                                                                   Industries Federation, for the sum of £…………


Mmw/budget/payment form.doc
Mmw/budget/payment form.doc

								
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