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PLEASE COMPLETE AND RETURN

by the 30 September 2013 if you are not taking out a tuition fee loan and wish to pay your tuition fees by instalments.

Staffordshire University (Payment of Tuition Fees) Instruction to your Bank or Building Society to pay by Direct Debit

Please Complete This is not part of the Instruction to your Bank or Building Society Student’s full name:

Please fill in the form and send it to: Financial Services (Direct Debits) Staffordshire Univeristy, Beaconside, Stafford, Staffordshire, ST18 0AD

Student number:

Name and full postal address of your Bank or Building Society Account Holders Address: To: The Manager

Bank/ Building Society

Address

Postcode

Payments to be taken on 8th 22nd Monthly payments Termly payments Name(s) of Account Holder(s)

Branch Sort Code

Bank/Building Society account number

Please pay Staffordshire University Direct Debits from the account detailed in his Instruction subject to the safeguards assured by the Direct Debit Guarantee.

I understand that this instruction may remain with Staffordshire University and, if so, details will be passed electronically to my Bank/Building Society.

Signature(s)

This guarantee should be detached and retained by the payer.

The Direct Debit Guarantee

Date

• 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 Staffordshire University will notify you 7 working days in advance of your account being debited or as otherwise agreed. If you request Staffordshire University 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 Staffordshire University 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 Staffordshire

University 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.

Originators Identification Number

8 3 6 2 1 2

Student Card

2013/2014

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To ensure that your student card is ready for collection at the start of term please use the form overleaf to forward a passport photograph to the University by 11 September 2013. Alternatively, upload your photograph. Details inside. You will need your student card to gain entry to the Students’ Union, to use the Library, to use IT facilities and to initiate your first loan payment.

Please attach

Please attach a passport photograph with your UCAS number written on the back

passport photo

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Name (print name):

Campus: Stoke/Stafford

delete as appropriate

Course: Date of birth:

Please return to the address below.

UCAS number: Home address:

Please return this form to: Information Centre Staffordshire University FREEPOST ST655 College Road Stoke-on-Trent ST4 2BR

M4881CBS 07/13