Set Up a Direct Debit

Your Personal Details

Mr/Mrs/Miss/Ms/Other

First name

Surname

Address

Postcode

Tel No

Supporter No (if known)

I would like to donate £................ each month/quarter/year (delete as appropriate)
starting on or around ...................

Name(s) of account holder(s)

Name and full postal address of your Bank or Building Society

To The Manager Bank or Building Society

Address

Postcode

Branch sort code

Banks and Building Societies may not accept Direct Debit instructions for some types of account
Gift Aid Declaration

Use Gift Aid and you can make your donation worth more. For every pound you give to us, we get an extra 28 pence from the Inland Revenue. It’s that simple.

There is no need to sign this if you have already completed a Gift Aid form for Explore. Thank you.

I am a UK tax payer and want Explore to treat all donations I’ve made since 6 April 2000 and all donations in the future to beGift Aid donations (until I notify you otherwise).

Title

First name

Surname

Address

Postcode

Signature Date
To qualify for Gift Aid what you pay in income tax or capital gains tax must at least equal the amount we will claim in the tax year

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 yourown bank or building society.

If the amounts to be paid or the payment dates change Crisis will notify you 10 working days in advance of your account being debited or as otherwise agreed
From time to time we may contact you by telephone, but if you would prefer us not to contact you in this way, please tick
If you would prefer not to be contacted by Explore again, please tick
(Please note we may have to contact you occasionally in relation to your Direct Debit)
We sometimes allow like-minded organisations to write to you. If you would prefer not to hear from them, please tick

Our reference: WRG/AY/0/024

Fighting for hope for

homeless people
2
1
3

Bank or Building Society account number

Reference Number (for office use only)

Instruction to your Bank or Building Society.

Please pay Explore Direct Debits from the account detailed on this instruction subject to the safeguards assured by The Direct Debit guarantee. I understand that this instructionmay remain with Explore and if so, details will be passed electronically to my Bank/Building Society

Signature(s)

Date

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

You can cancel a direct debit at any time by writing toyour bank or building society. Please also send a copy of your letter to us.
The Direct Debit Guarantee
Please detach and keep the Direct Debit guarantee.
Send the rest of the form to Explore, The EWR Centre, Cloudesley Street, London N1 0HU
Origination identification number

8 0 6 2 2 7
Instructions to your Bank or Building Society to pay Direct Debit
Please fill in the whole form and send it to:
Explore, The EWR Centre, Cloudesley Street, London N1 0HU