Direct Debit Form

Download a paper Direct Debit form here

Direct Debit Guarantee

This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits.
If there are any changes to the amount, date or frequency of your Direct Debit, Bromley Mencap will notify you 10 working days in advance of your account being debited or as otherwise agreed.
If an error is made in the payment of your Direct Debit by Bromley Mencap or your Bank/Building Society, you are entitled to a full and immediate refund of the amount paid from your Bank/Building Society.
You can cancel a Direct Debit at any time by simply contacting your Bank/Building Society. Written confirmation may be required. Please also notify us.

Direct Debit

Name on Membership:

Membership Number (this starts with BM):

Email Address:

Memberships are £20. If you wish to pay more than this, or pay for multiple memberships, please specify the amount you wish to pay:

Name of Account Holder(s):

Bank/Building Society Account Number:

Branch Sort Code:

Name and full postal address of your Bank/Building Society:

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

I confirm that I am the account holder and the only person required to authorise Direct Debits on this account.

I am happy to receive updates from Bromley Mencap by:

Post

Phone

Date

Direct Debit Form

Bromley Mencap is proud to have the following accreditations

Advice helpline: 020 8466 0790

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