Bild Subscription Form

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Student Details

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Family Carer Details

To verify your role as a family carer, please may you provide the following information to us. This information will be stored in our secure CRM.

Your relationship to the person with learning disabilities:

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The age of the person with learning disabilities who you care for:

Details of diagnosis that you would like to give:

Payment Details

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Credit Card - Please debit my Credit CardCheque made payable to 'Bild'One off Direct Debit (5% discount)Monthly Instalments (10 Months)Please Invoice me (if over £30 and please provide address if different than above)

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Notice

If you have any issues with card payments, please reach out to us at subscriptions@bild.org.uk or on 0121 415 6960.

Direct Debit Details

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Direct Debit Guarantee:

If you cancel the direct debit during the course of the membership, you will be liable to pay the remainder via credit card or invoice.

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Postage (Good Autism Practice):

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Total (incl. VAT):

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(5% discount applied)

Total (incl. VAT):

(5% discount applied)

Total (incl. VAT):

(5% discount applied)

I agree to the processing of my personal information by Bild for the purposes of contacting me and sending me information about my Bild Subscription.

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If you have any issues with this form, please contact subscriptions@bild.org.uk with details of any errors that have occured so we can address this as soon as possible. Many thanks.

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