Direct Debit Mandate Step 1 of 10 10% Thank you for choosing to pay via Direct Debit. We need to carry out a number of checks to set up the Direct Debit Instruction with your bank. Please ensure that you complete all details accurately.Have you applied to The JCB Academy Trust for Financial Assistance?(Required) Yes No As you have applied for Financial Assistance, your payment method will be via Parent Pay. Therefore, a payment item for Academy Transport will be set up on your Parent Pay account within 5 working days* If you need to contact our finance department to discuss alternatives please email finance@jcbacademy.com or contact 01889 506100. * This may take longer if you’re currently completing this form within the school holiday period. Please can you confirm that you hold a UK Bank / Building Society Account and you are the Account Holder?(Required) Yes No As you have answered 'No' you will need to contact our finance department to discuss an alternative payment process on 01889 506100. Please can you confirm that you are the only person required to authorise debits from this Account?(Required) Yes No As you require a joint signature on your bank account, your alternative payment method will be via Parent Pay. Therefore, a payment item for Academy Transport will be set up on your Parent Pay account within 5 working days* If you need to contact our finance department to discuss alternatives please email finance@jcbacademy.com or contact 01889 506100. * This may take longer if you’re currently completing this form within the school holiday period.If you are happy to proceed, please click continue If you do not wish to proceed any further, please click cancel Direct Debit Guarantee The 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 The JCB Academy Trust will notify you (10 working days) in advance of your account being debited or as otherwise agreed. If you request The JCB Academy Trust 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 The JCB Academy Trust 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 The JCB Academy Trust 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 The JCB Academy Trust. For further information about Direct Debits, please visit https://www.directdebit.co.uk/Bank Account DetailsName of bank(Required) Name on bank account(Required) Account Number(Required) Sort code(Required) Payment Options Option1: 10 monthly payments of £75, which will be collected each month from 1 August 2023. Payment will be taken on the first working day of each month, with the final payment being taken on 1st May 2024. Option2: 1 payment of £750 will be collected at 1 August 2023 or the first working day thereafter. I would like to pay:(Required) 10 monthly payments of £75 1 payment of £750 HiddenMonthly(Required) Monthly HiddenAnnually(Required) Annually HiddenFirst collection date(Required) 1 September, 2023 Date: 30th November 2023 HiddenCannot complete onlineParent/carer details Please provide details for Parent Pay paymentsParent name(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Last Contact telephone number(Required) We will need this if we encounter a problem or need to speak to you about the application. Email(Required) Enter Email Confirm Email ImportantEmail confirmation(Required) I understand that I will receive an email containing important information when I complete this form I have checked the email address I have entered and it is correct I understand the need to check my junk folder if I do not receive the email within 15 minutes Learner detailsLearner name(Required) First Last Year group(Required) Year 9 Year 10 Year 11 Year 12 Year 13 Apprentice Your payment method will be via Parent Pay and not a bank Direct Debit. Confirmation of bank detailsName of bank: {Name of bank:8} Name on bank account: {Name on bank account:1} Account Number: {Account Number:5} Sort code: {Sort code:12}Confirmation(Required) I confirm that the above bank details are correct You will receive an email containing the below information when you submit this form. 1. Confirmation of the Direct Debit Instruction 2. The Contact Details of The JCB Academy 3. The Direct Debit Guarantee The JCB Academy can be contacted in the following ways: 4. The Direct Debit set up will be sent by email within 3 working days or no later than 10 working days before the first collection date. 5. The Paperless Confirmation will be issued by email within 3 working days of the sign-up process. By post: The JCB Academy Trust, Mill Street, Rocester, Staffordshire, England, ST14 5JX By phone: 01889 506100 By email: finance@jcbacademy.com Data ProtectionWe take spam very seriously and any personal information we collect from this website will be used in accordance with the Data Protection Act 2018 and other applicable laws. For more information about our privacy practices please visit our privacy policy page on our website. By clicking below, you agree that we may process your information in accordance with these terms. The Data Controller is The JCB Academy Trust.CAPTCHACommentsThis field is for validation purposes and should be left unchanged.