Docstoc

Become a member of WSPA by Direct Debit

Document Sample
Become a member of WSPA by Direct Debit Powered By Docstoc
					Make a regular gift to WSPA by Direct Debit

 Title                First Name                                                        Surname
 Address
                                                                                        Postcode
 Telephone Number                                                                       This is my   Home     Work       Mobile number
 Email address                                                                          Can we contact you via email?        Yes       No

 I would like to give:                £5      £10         £                other (minimum £3) every month
 (These are just suggestions and whatever you feel you would like to contribute is always appreciated)

 starting on            1st           8th      15th           22nd    of each month
 (If no date is specified, payments will be collected on the first day of each month)

Your support is vital to the work we do and we thank you for it. We also respect your privacy and would assure you that WSPA fully
comply with the Data Protection Act (1998). From time to time we may want to pass your details to other similar organisations that you
may also feel able to support. If you do not want us to do this, or do not wish to receive future communications from WSPA please tick
the relevant box.
  I do not wish you to pass any information you hold on me to any other parties.
  I do not wish to receive any future communications from WSPA or WSPA Trading



 Instruction to your Bank or Building Society to pay by Direct Debit
 Please fill in the form and return it to: WSPA, Dept IW5, FREEPOST SCE6686, Melksham SN12 6GZ
 Name and full postal address of your Bank or Building Society

    To: The Manager                                                                                                Bank/Building Society

    Address

                                                                                         Postcode

 Name(s) of account holder(s)




 Branch sort code                           Bank/Building Society account number
                                                                                                            Banks and Building Societies may
                                                                                                            not accept Direct Debit Instructions
                                                                                                            for some types of account.
 Originator’s identification number         WSPA reference number (for office use only)
   4 0 6 0 6 0


 Instruction to your Bank or Building Society Please pay WSPA Direct Debits from the account detailed on this instruction
 subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with WSPA and, if
 so, details will be passed electronically to my Bank or Building Society.


    Signature(s):
    Date:



PLEASE TEAR OFF AND RETAIN
This guarantee should be detached and retained by the Payer.
The Direct Debit Guarantee
This Guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme. The efficiency and security of
the Scheme is monitored and protect by your own Bank or Building Society. If the amounts to be paid or the payment dates change
WSPA will notify you 10 working days in advance of your account being debited or as otherwise agreed. If an error is made by WSPA
or your Bank or Building Society, you are guaranteed a full and immediate refund from your branch of the amount paid. You can cancel
a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us.

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:11
posted:3/9/2011
language:English
pages:1