Payment Remittance Form

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Please fill in this form every time you make a payment to the St Albans Account for payments to be recorded correctly. This should be completed once per transfer to the account.

Any payments that come in without a form will not be recorded on your balance.

Account name: St Albans Ultimate
Account number: 82250195
Sort Code: 40-40-01

Reference: Please reference the transfer with your name for easy identification

Full name *

Please Enter your full name (forename and surname)

Payment Date *

YYYY

How much are you paying? *

Please enter the full amount you have transferred to the bank account.

Reason for payment? *

Please tick the option/s that are applicable

Membership

Training

Tournaments

Other:

Required

Name on bank transfer if different from known name

Optional

Submit

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