Direct Debit Form

Charity Name: Oracle Cancer Trust
Instruction to your Bank or Building Society to pay by Direct Debit.
Bank/Building Society*
Address*
Street Address Address Line 2 City County Post Code Country
Name (s) of Account Holder
Name 1 Name 2
Bank/Building Society account number*
Bank Sort Code*
Example: 404040
Consent*
I agree to the instructions to my Bank or Building Society
Instruction to your Bank or Building Society
Please pay Charities Aid Foundation 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 Charities Aid Foundation and, if so, will be passed electronically to my Bank/Building Society.
Your Information
This is not part of the instruction to your Bank or Building Society.
Your Name*
Prefix First Last
Your Address*
Street Address Address Line 2 City County Post Code Country
Email*
Enter Email Confirm Email

We will only use this email address in relation to the set-up and running of the Direct Debit.
Donation Details
I would like to make a regular donation of £*
*
- Monthly
- Quarterly
- Half yearly
- Annually
Commencing on*
Day of the month
Month and year*
Month Year
Gift Aid Declaration
Tick to apply
Please Gift Aid this donation and any donations I make in the future or have made in the past 4 years. I am a UK taxpayer and understand that if I pay less Income Tax and /or Capital Gains Tax than the amount of Gift Aid claimed on all my donationsin that tax year, it is my responsibility to pay any difference.

Please notify us if you want to cancel this declaration, change your name or home address or if you no longer pay sufficient tax on your income and/or capital gains.
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Name
This field is for validation purposes and should be left unchanged.

The 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, Charities Aid Foundation will notify you ten working days in advance of your account being debited or as othersie agreed. If you request Charities Aid Foundation to collect a payment, confirmation of the amount and date will be given to you at the time of the request.
If an error is made in the payment of your Direct Debit by Charities Aid Foundation or your Bank or Building Society, you are entitled to a full and immediate refund of the amound paid from your bank or building society – If you receive a refund you are not entitled to, you must pay it back when Charities Aid Foundation asks you to.
You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Written confirmation may be required. Please also send copy of your letter to us.

Head & Neck Cancer

Types of Head & Neck Cancer

Patients and Carers

Get in touch

Call 0203 475 3471

Email info@oraclehnc.org.uk

Oracle Head & Neck Cancer UK is a registered charity in England and Wales (1142037), and in Scotland (SC052790).

Registered as a company limited by guarantee in England and Wales (7125497). Registered address: 80 Coombe Road, New Malden KT3 4QS.

Direct Debit Form

Charity Name: Oracle Cancer Trust

Your Information

Donation Details

The Direct Debit Guarantee