NPO no: 132-580


a pair of shoes.

Millions of children die every year from foot-borne diseases. Shoes are required for prevention and protection. Join Samaritan’s Feet today and help us eliminate this epidemic, while making the world a better place.

Debit Order Authorisation

I wish to make a monthly contribution towards SAMARITAN’s FEET SA. I therefore request and authorise you to debit my account at the bank mentioned below (or other bank or branch to which I may transfer my account) with

Scheduled Debit Order Date
The first deduction is to take place on
I also authorise you to debit my account with once off amounts from time to time as and when intructed by me per email/in writing

The details of my bank account are as follow:

Type of account

I understand that the deductions hereby authorised will be processed by means of a system known as Sanlam Multi Data Services, and I understand that the details of each deduction will be reflected on my bank statement and on an accompanying printed slip, with the reference MULTID FOR SF with my unique number. I also understand that I have to quote this reference in my communication with Samaritan’s Feet. I agree to pay any bank charges relating to this debit order. This authorisation may be cancelled by me by giving you 30 (thirty) days written notice. I understand, however that I am not entitled to a refund of amounts deducted by you while this authorisation is valid. The receipt of this instruction by you is considered tantamount to my bank acknowledging receipt thereof.
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