Please complete the form below to allow us to activate your debit order. R* Donation amount (in words)* My debit order should go:* Where needed most Other If other, please specify Name Surname* Cell number Email* Name of account holder* Account Number* Bank*Select your bankABSAStandard BankFirst National BankNedbankCapitecOtherABSA Branch Code: 632 005Standard Bank Branch Code: 051 001First National Bank Branch Code: 250 655Nedbank Branch Code: 198 765Capitec Branch Code: 470 010Bank* Branch* Branch Code* Type of account* Cheque Transmission Savings Date on which account should be debited* 1st 17th 25th Time period* 3 months 6 months Effective from* DD slash MM slash YYYY Consent* I agree to the Terms and Conditions* Δ
