HRA Renewing Member - paying by Direct Bank Transfer

Renewing Member paying by Direct Bank Transfer
I would like to renew my membership of Highfield Residents’ Association and make the appropriate subscription payment:

You MUST complete and submit this form
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
Your Data Protection Consent is continuous with your membership.

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 and a secure, automated email will arrive with your next instructions in order to pay by Direct Bank Transfer (BACS). This email may take up to 5/10 minutes to arrive. Please check your spam/junk folder if you can't see it in your inbox after this period. 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 Renewal
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:

Renewing Member paying by Direct Bank Transfer