Warning: Cannot modify header information - headers already sent by (output started at /home4/bodymin2/public_html/fns_tinymce.inc:43) in /home4/bodymin2/public_html/tracking.inc on line 46
Debit Order - Body and Mind - Natural, Alternative Health and Wellbeing Directory & Store

 



















 
 

(To Print this page Click Here)

Body and Mind Debit Order Authorisation:
www.bodyandmind.co.za 
Tel: 031-4643247 / Fax: 031-4641092

Debit Order Authorisation:
 
Your Name:  
Contact Number:  
ID Number:  
Address:  
   
Email Address:  
   
Bank Name:  
Account Name  
Type of Account:  
Account Number:  
Branch Name:  
Branch Code:  
   
If you are paying by credit card :  
Expiry Date  
Master card or Visa  
CVC number  
Card number  
   
Amount to be debited  R


I certify that the above bank details are correct and I authorise Body & Mind to debit my account with my membership fee & other requested advertising fees on the 28th of every month. If these banking details have not been provided accurately, or if the details change at any time in the future & if I/we fail to notify Body & Mind of such changes, or if payment is not made in accordance with a Debit Order Instruction, the responsibility for payment will rest with me/us. Membership agreements are for a minimum of 6 Months and the onus is on the Customer to cancel, providing us as per the Debit Order form agreement, a 30 Day notice of such cancellation



All such withdrawals from my/our bank account by you shall be treated as though they had been signed by me/us. This authority may only be cancelled by me/us giving 30 days' notice in writing.

Please NOTE: On your bank statement your debit's reference will be : PREMIUMCOLRF00000000(8digits)BODY******

Subscriptions are paid in advance.


Date:______________________________



 
__________________________ __________________________
Authorised Signatory Name of Signatory


 

 

 



















 
Google
Enter your search terms
 

              

Submit search form
Canada prescriptions online
for less at

NorthWestPharmacy.com



Some great products from our Shopping Centre

The Cosmic Traveller - 2012 to 2020

More astonishing revelations come to light when, due to an explosion under the construction site at the Valley of the Gods resort in France, ancient underground tunnels are discovered. Embedded in the rock walls pictographic script foretells a future that seems to have happened in the past.This thir



Benutriwise Health & Wellness Software

Benutriwise Health & Wellness Software is the ultimate healthy lifestyle tool. Set and manage you and your family's health goals easily. Monitor the nutritional value of the meals you eat utilising the nutrition database that has over 2000 pre-loaded foods from S.A.'s major food manufacturers. Re



The Reiki Experience - People living with HIV / AIDS

The Reiki Experience - People living with HIV / AIDS

This book is based on a research to investigate:The Reiki Experience - People living with HIV / AIDS

This book is based on a research to investigate:
"The role of Reiki Therapy in improving the quality of life of people



Smoothies

Fruity and fresh, or indulgent and rich – whatever your taste buds crave there’s a smoothie or shake inside to suit the occasion or mood. Keep it fun and simple for the kids with a Cheeky Monkey or sample the sinful delight of Hazelnut Heaven when you’re home alone.
Alternatively, make breakfa




 


Sitemaps :- Therapist   Information   Products    

DISCLAIMER:

The information and views expressed on this site are not necessarily the views of the Body & Mind staff. We are not
responsible or liable for any inaccuracy. We apologise if any offence is taken.

© Body and Mind 2000-2012. All Rights Reserved.



FaceBook Twitter digg Body and Mind Body and mindLinkedIn Icons



Designed by Webcoza