AFFILICA MEMBERSHIP - PAYMENT
Affilica International Subscription

Affilica Membership (Enter the amount agreed / invoiced)

Monthly

GBP

Affilica Membership (Enter the amount agreed / invoiced)

One-Off

GBP

Terms & Conditions

1. Monthly payments are taken automatically from your plastic card.
2. Secure payment by Debit/Credit Card (No American Express or Diners Card or Maestro or Solo).
3. Payer to print on-screen VAT invoice and retain; no invoice sent in post.
4. Membership is activated after the payment setup is complete.
5. Membership terms are detailed in membership agreement sent separately.
6. To stop payments in the future you need to contact us to set up cancellation.

Agreed unconditionally.
Member's details
*Fields must be completed  
*Person
*Email address
*Telephone number
*Organisation/Firm/Co
*Address
*City
*Post Code*
*Country
Located in UK
VAT at 20%
in EU
 (your VAT Number in box = no UK VAT to pay)
outside EU
at zero VAT
Debit Card
Credit Card
Bank Transfer
[We do not take AmEx or Diners Card]
Special instructions:
Company's Details
Company Registration Name: Affilica InPractice Software Ltd.
Company Registration Number: 1969932
Place of Registration: Companies House, U.K.
Address: 3rd Floor, 207 Regent Street, London W1B 3HH, U.K.
Letters/Parcels to: 4 Chiswick Place, Eastbourne BN21 4NH, U.K.
Tel: +44(0)1323 722 106
Email: Click here to email