Give Monthly

Have you ever thought about becoming a monthly donor to The Alzheimer Society of Ireland (ASI). By receiving monthly donations, ASI can plan and budget for the future.

Your monthly donations are automatically deducted from your bank account on a regular basis using the form below or by Credit / Debit card here.

Monthly Direct Debit

Direct debits are an easy and efficient way to make a regular donation. They really help to reduce our administration costs and allow ASI to plan for the future.

Make a monthly donation by SEPA Direct Debit

Please complete and submit this form to set up a paperless monthly direct debit using SEPA Direct Debit.

When we receive this form we will send you a confirmation letter indicating the details of your direct debit donation with The Alzheimer Society of Ireland. You will also receive an email immediately acknowledging receipt of this form.

The information you have provided will be kept securely and used by The Alzheimer Society of Ireland in order to make your monthly donation possible. Your information will only be shared with selected third party service providers, contracted by The Alzheimer Society of Ireland to assist with our campaigns. Your information will not be shared with any other organisation, other than with your permission, or where required by law.

Note 1: your direct debit will be taken on the 15th day of each month or next working day.

 

SEPA Direct Debit instruction

Fields with * are required.

How much would you like to donate each month? *

If you donate more than €250 in one year, we can claim tax back at no extra cost to you.

Note: Please allow up to 21 days before your first Direct Debit is processed. This may delay the first of your Direct Debits.

Personal details

Title *
First name *
Last name *
Address line 1 *
Address line 2
Town / City *
County *
Country *
Eircode / Post code
Phone *
Email address *
Re-enter your email *

Please select how you would prefer us to get in touch with you:

Marketing email opt-in Phone opt-in Post opt-in

Bank account details

Account Holder Name(s) *
Branch Identifier Code (BIC) *
Account Number (IBAN) *
Is this bank account in the Republic of Ireland? *

Paperless SEPA Direct Debit cannot be set up for non-Republic of Ireland bank accounts

Is more than one signatory required to sign on your account? *

Paperless SEPA Direct Debit cannot be set up for dual signatory bank accounts

Can your bank account accept Direct Debit? *

Creditors Identifier Number (CI):

IE62SDD306600

By completing this form I consent to authorize The Alzheimer Society of Ireland to set up a monthly direct debit and to debit my account accordingly as per the information I have provided above.

 

Note: You will also receive an email immediately acknowledging receipt of this form.

 

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