Colts payment mandate 2021-2022

Please use this form to submit your direct debit details to the Club. Your account will be automatically billed the amount specified at the bottom of the form. After successful submission of the form, you will be redirected to pay the league registration fee.


Player's name:



Player's age group:



Team colour:



Payee's name:



Payee's address:



Payee's postcode:



Bank name: 



Bank address:



Bank postcode:



Account number:



Sort code:



Please pay from my account to: Haverhill Rovers Ladies and Youth

Bank: Barclays Bank plc, 39 High Street, Haverhill, Suffolk, CB9 8AE

Account number: 23926605

Sort code: 20-74-05

Amount: £45 (forty-five pounds)

Payments to be made quarterly, on the (please select day) of August 2021, October 2021, December 2021 and February 2022

Leave this empty:

Signature arrow

Signature Certificate
Document name: Colts payment mandate 2021-2022
lock iconUnique Document ID: ab1746557f2a8e2d6cda4353fb125be0773e1c94
Timestamp Audit
20th July 2021 12:27 pm BSTColts payment mandate 2021-2022 Uploaded by Peter Betts - IP