Birmingham Quran Academy Direct Debit Form

Birmingham Quran Academy Direct Debit Form

Dear parents, Please note that a separate direct debit form has to be filled out for each child.

Parent's Name *

Name on bank account

Student's Name *

Child's Name

Student ID:

(official use only)

Address: *

Postcode *

Contact number *

Telephone / Mobile

Email *

Bank Name *

Sort Code *

Account number *

Amount per month *

Direct Debit Date

Originator’s Identification Number: 840575 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 Birmingham Quran academy will notify you 10 working days in advance of your account be debited or as otherwise agreed. If you request Birmingham Quran academy 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 you direct debit, by the Birmingham Quran Academy or your bank or the building society you are entitled to a full and immediate refund of the amount paid from your bank or building society – If you receive a refund you are not entitled to, you must pay it back when the Birmingham Quran Academy asks you to. You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

Submit