HRA New Member - paying by Direct Bank Transfer

New Member paying by Direct Bank Transfer
I would like to become a member of Highfield Residents’ Association and make the appropriate subscription payment:
Surname*
First Name*
Title*
Address House Number / Name*
Street*
City *
Post code*
Telephone landline
Telephone mobile
Email address*
example@example.com
Membership number
* required fields
Please note: the applicant is responsible for agreeing on behalf of all individuals in the household who live at the above address.
To make payment - complete and submit this form. You will immediately receive a secure email acknowledgement. This will inform you that a second secure email will follow, with instructions on how to pay by Direct Debit Transfer (BACS). This second email may take up to 5/10 minutes to arrive. Please could you check your spam/junk folder if you can’t see it in your inbox after this period. Check your bank details to confirm that the payment has been made. Thank you. Contact: highfieldracomms@gmail.com for further help.

Please note it is not possible to pay using a Bank or Credit Card. Pay direct to the bank details provided to complete your application. Check the funds have left your account.

Once payment has been processed, the Membership Secretary will send you your new Membership card(s). This may take 7-10 days.
Household membership
Additional Membership Cards, £3.00 each
Name(s) on additional card(s)
Voluntary donation (£)
Total amount
Today's Date

DayMonthYear
dd-mm-yyyy
Should be Empty:

New Member paying by Direct Bank Transfer