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
Customer Ref:


Until further notice

Payment Information

Payment Day:
First Payment Date:
15 December 2020
I wish to pay a regular Direct Debit of:

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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