Personal Details

Details
*Title
*First Name
*Surname
*Contact No
Mobile No
Date of Birth
*Email Address
*Confirm Email
Address
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*Postcode
*Address Line 1
*Town
County
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Hyde High Rollers working with

Hyde High Rollers
Willow Wood Hospice
Willow Wood Close
Ashton under Lyne
OL6 6SL
DDLogo


For any queries contact our Supporter Care No: 0161 330 1133

You will need your account details, which can be found on your cheque book or bank statement, to complete the direct debit instruction. Is the account in your name? Are you the only signatory required to authorise this direct debit? If not, please click here for a paper mandate (PDF format) which should be printed off and sent to us with all necessary signatures.