Please contact treasurer or secretary for bank details
The sum of £…………………… (…………………………………………………………)
FIGURES WORDS
Commencing on the ……………………………………………………………………………….
DATE
And hereafter every…………………………………………………………………………………
DATE AND FREQUENCY
Until…………………………………………………………………………………………………
DATE OF LAST PAYMENT
And debit my Please Quote Reference No. (for official use only)
Account number
Sort Code
Date …………………………..
Signature ………………………………………..
ADDRESS……………………………………………………………………………………………………………………………………………………………………………………………………