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To make a regular donation by Direct Debit
Please enter the details below - you will have a chance to review and confirm the payment before it is made.
Are you the only person required to authorise debits from this account?	YesNo	More Info
Are you the Account Holder, and therefore the Payer of the Direct Debit?	YesNo	More Info

Payment Details

I would like to support Caudwell Children with a monthly Direct Debit of:

£10£20£50Other Amount

Other £

Please begin debiting my bank/building society account starting on:

Must be at least one month from today

Day Month Year

	Using Gift Aid means that for every pound you give to Caudwell Children, we get an extra 28 pence from the Inland Revenue making your gift go further. Just tick here it's that simple.
		Please treat all my donations since 6 April 2000 and until further notice as Gift Aid. I confirm I pay an amount of income tax and/or capital gains tax at least equal to the tax that Caudwell Children will reclaim on my donations in the tax year.

*Your Details Mandatory Fields**
Title*	First Name*		Surname*
House Number	Postcode*
Address Line 1*		Contact Phone Number*
Address Line 2*		Email Address
Address Line 3
Address Line 4		We would like to send you occasional updates about our work Please tick here if you DO NOT wish to receive this

Instruction to your bank / building society to pay by Direct Debit

The Caudwell Children
Minton Hollins Building
Shelton Old Road
Stoke on Trent
ST4 7RY

Name of Account Holder *

Bank/Building Society
Account number*

Branch Sort Code*

- -

Originators Identification Number

Reference (for office use only)

Name & full postal address of your Bank/Building society*

To the Manager: Bank/Building Society Name

Instructions to your Bank or Building Society.

Address of Bank/Building Society

Please pay the Caudwell Children Direct Debits from the account detailed in this instuction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instuction may remain with the Caudwell Children and, if so, details will be passed electronically to my Bank/Building Society.

Date (dd/mm/yy)

Bank and Building Societies may not accept Direct Debit Instructions for some types of accounts.

The Direct Debit Guarantee

- This Guarantee is offered by all banks and building societies that take part in the Direct Debit Scheme. The efficiency and security of the scheme is monitored and protected by your own bank or building society.

-If an error is made by the Caudwell Children or your bank or building society, you are guaranteed a full and immediate refund from your branch of the amount paid.

- If the amount to be paid or the payment dates change, the Caudwell Children will notify you 10 working days in advance of your account being debited or as otherwise agreed.

- You can cancel a Direct Debit any time by writing to your bank or building society. Please also send a copy of your letter to us.

	Registered Charity No: 1079770 Company No: 3864620