Midlands Air Ambulance Charity, Hawthorn House, Dudley Road, Stourbridge, DY9 8BQ
UK Registered Charity Number 1143118

General Enquiries: info@midlandsairambulance.com  
Tel: 0800 8402040, Fax: 01384 486621

Schedule

Termination:
Until further notice

Payment Information

Payment Day:
2017
First Payment Date:
15 October 2017
I wish to pay a regular Direct Debit of:
£1.00

Personal Details

 
 
 
 
 

Additional Information

 
 

Instruction to your Bank or Building Society to pay by Direct Debit

MAAC, Midlands Air Ambulance Charity, Hawthorn House, Dudley Road, Stourbridge, DY9 8BQ

Service User Number:
 

 

Checking the box indicates that I am the Bank/Building Society holder and no authority other than my own is required. If more than one person is required to authorise debits from the account, you are unable to setup a direct debit online.

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