Debit Form - Feba Radio

Amount in R *

Amount (in words) *

Commencing (month of first debit)

(Debits take place around the 2nd of every month. To avoid charges, please give us two weeks' notice to stop a debit order)

I wish to add 10% annually *

Yes

No

Email Address *

Bank *

Type of Account *

Branch Code *

Account Number *

Title *

Name & Surname: *

ID Number *

Postal Address *

Code *

Telephone *

Church / Organisation

Newsletter Sign Up

Yes

No

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