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Membership Payment Form

Payment Amount
1. IET Subscription fee £ 2. I would like to donate £5 or £ to IET Connect, the Institution’s Benevolent Fund1.

I am a UK taxpayer and would like IET Connect to reclaim the tax on this and all future payments under the Gift Aid Scheme.
3. Total £
IET Connect, the Institution’s Benevolent Fund asks each member to donate at least £5 with their membership subscription each year. For more information on the services
1

available visit www.ietconnect.org. IET Connect is a separate registered charity affiliate.


Direct Debit is the IET’s preferred method of payment as it helps keep our costs to a minimum and therefore ensures that your membership fees are put to best use in future.
Please complete the Direct Debit instruction below and return the whole page to us in the envelope provided.
I wish to pay by:

CARD DIRECT DEBIT STERLING CHEQUE/BANK DRAFT


Please complete the Payment By Card section below. Please complete the Direct Debit Instruction below. Please make this payable to The Institution of
Engineering and Technology.

Payment by Card Card Number


I authorise you to charge my Visa/
Mastercard/American Express/
Maestro/Delta (delete as Valid from Expiry date Issue Security
appropriate) with: [m][m][y][y] [m][m][y][y] Number Code

A one off payment of the Name on credit card


amount stated in Section 3 above
for my current year’s subscription, Address
which will be taken on receipt of
this instruction.

A payment of the amount Postcode


stated in Section 3 above for my
current year’s subscription, which Country
will be taken on receipt of this
instruction. I understand that Signature
payments of unspecified amounts
for future year’s subscriptions will be Date
taken as and when they become
due (Visa/Mastercard only) and Membership Number (Please complete if applicable)
that I will be given prior notice
in writing.

Instruction to your Bank or Building Society to pay by Direct Debit Service User Number
Please fill in the whole form using a ball point pen and send to:
The Institution of Engineering and Technology, PO Box 96, Stevenage, SG1 2SD, United Kingdom
9 2 0 0 1 5

Name and full postal address of your Bank or Building Society Reference (for office use only)

To: The Manager Bank/Building Society


Instruction to your Bank or Building Society
Address Please pay the Institution Direct Debits from the account
detailed in this instruction subject to the safeguards
assured by the Direct Debit Guarantee. I understand
Postcode
that this instruction may remain with the Institution and,
if so, details will be passed electronically to my Bank/
Building Society.
Name(s) of Account Holder(s)
Signature(s)
Bank/Building Society Account Number Branch Sort Code

Date

✂ 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 take part in the Direct Debit Scheme.
■■The efficiency and the security of the Scheme is monitored and protected by your own Bank or Building Society.
■■If the amounts to be paid or the payment dates change, the Institution will notify you 14 working days in advance of your account being debited or as
otherwise agreed.
■■ If an error is made by the Institution or your Bank or Building Society, you are guaranteed a full and immediate refund from your branch for the amount paid.
■■You can cancel a Direct Debit at any time in writing to your Bank or Building Society. Please also send a copy of your letter to us.