Monthly Donation

Thank you for choosing to donate to the Mercy University Hospital Foundation
To sign up for a monthly direct debit, please fill in the information on this form

Your Details
Eircode (your Eircode has 7 characters)

Would you like us to keep you updated about the fundraising appeals of the Mercy Hospital Foundation? Tick or untick the boxes as you wish.

(we have just two mail campaigns a year)
(we will never ring you more than three times a year)
(we can send you our monthly e-zine with updates, stories and more)
Your Bank Details
IBAN stands for International Bank Account Number. It contains your Bank Account Number and a new code so that your bank account can be used throughout the EU. An example of an IBAN: IE99AIBK90000012345678

Your IBAN can be found on your bank account statement.

BIC stands for Bank Identifier Code. BIC codes are specific to each bank within the EU (replacing sort codes). They can be found on your Bank statement or can be requested from your bank. Your BIC can be found on your bank account statement.

(please note, you can contact us to change your communication settings by ringing 021-4274076, emailing or writing to 9 Dyke Parade, Cork, T12 EY91. Our full data protection/privacy policy is available by clicking here)

Your Rights - Data Protection and Cookie Policy

SEPA Direct Debit

You are currently being signed up to a SEPA direct debit. This means that no signed paper Direct Debit instruction is required. When you complete your donation we will send you a letter indicating the details of your direct debit donation with Mercy University Hospital Foundation. Creditor Identifer: IE53ZZZ361082

Mercy University Hospital Foundation, 9 Dyke Parade, Cork, T12 EY91, Cork, T12 EY91. Tel. 021 4274076

By completing this mandate form, you authorise (A) Mercy University Hospital Foundation to send instructions to your bank to debit your account and (B) your bank to debit your account in accordance with the instructions from Mercy University Hospital Foundation. As part of your rights, you are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within 8 weeks starting from the date on which your account was debited. Your rights are explained in a statement that you can obtain from your bank.