Customer Ref:
Schedule
Service/Schedule:
1. Monthly Service - 1. Monthly DD Schedule - Rolling
2. Annual Service - 1. Annual DD Schedule - Rolling
2. Annual Service - 2. Annual DD Schedule - Fixed
3. Quarterly Service - Quarterly DD Schedule - Rolling
4. Semi-annual Service - Semi-annual DD Schedule - Rolling
Termination:
Until further notice
Payment Information
Payment Day:
1
15
January
February
March
April
May
June
July
August
September
October
November
December
2024
First Payment Date:
15 May 2024
The first amount (if different to the regular amount) should be:
£
Total First Payment:
£
I wish to pay a regular Direct Debit of:
£
Personal Details
Title
---Select---
Mrs
Mr
Miss
Ms
Dr
Sir
Lord
Lady
Prof.
Rev.
Master
Mx
---Other---
First name
Surname
*
Line1
*
Line2
Line3
Line4
Post code
*
Home phone number
Mobile phone number
Work phone number
Email
*
Additional Information
1. Please select a fund type:
---Select---
Where need is greatest
Access and Outreach
Coronavirus Hardship Fund
Student Support
Graduate Scholarships
The Ancient World Fund
Lester B. Pearson Studentship
Library Fund
Boat Club
Tutorial System
*
2. I prefer to make this donation anonymously:
---Select---
Yes
No
*
Instruction to your Bank or Building Society to pay by Direct Debit
APS Re St Johns College, St Giles, Oxford, OX1 3JP
Service User Number:
Custom Bank Reference:
Account holder name
Account number
Bank sort code
Please tick to confirm you are the only person required to sign for this account
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.