Fillable Tuition Fee Direct Debit Mandate Form (Goldsmiths College, University of London)

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Tuition Fee Direct Debit Mandate Form (Goldsmiths College, University of London)

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Country of origin: UK
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Instruction to your
bank or building society
to pay by Direct Debit
Please fill in the whole form including official use box using a ball
point pen and send it to:
Service user number
Fees Office
Goldsmiths
University of London
New Cross
London SE14 6NW
6
7
8
0
2
0
FOR GOLDSMITHS' COLLEGE OFFICIAL USE ONLY
This is not part of the instruction to your bank or building society.
Please provide your 8-digit Student Number starting
with 33.
Student Number
3
3
Please tick one box below to indicate your preferred
instalment plan:
5 monthly instalments
3 termly instalments
Name(s) of account holder(s)
Bank/building society account number
Branch sort code
Instruction to your bank or building society
Please pay Goldsmiths’ College Direct Debits from the account detailed
in this Instruction subject to the safeguards assured by the Direct Debit
Guarantee. I understand that this Instruction may remain with
Goldsmiths’ College and, if so, details will be passed electronically to my
bank/building society.
Name and full postal address of your bank or building society
Address
Signature(s)
Postcode
Date
Reference
Banks and building societies may not accept Direct Debit Instructions for some types of account
This guarantee should be detached and retained by the payer.
The
Direct Debit
Guarantee
• This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits
• If there are any changes to the amount, date or frequency of your Direct Debit Goldsmiths’ College will notify you ten working
days in advance of your account being debited or as otherwise agreed. If you request Goldsmiths’ College to collect a payment,
confirmation of the amount and date will be given to you at the time of the request.
• If an error is made in the payment of your Direct Debit, by Goldsmiths’ College or your bank or building society you are entitled
to a full and immediate refund of the amount paid from your bank or building society
– If you receive a refund you are not entitled to, you must pay it back when Goldsmiths’ College asks you to
• You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be
required. Please also notify us.
or name here
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Tuition Fee Direct Debit Mandate Form (Goldsmiths College, University of London)

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Completed 4 February 2021

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