BANKER’S STANDING ORDER

Date . . . . . . . . . . . . . . . . . . . . . .

Branch address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Please pay to NatWest Bank, North Walsham Branch,

Sort Code 60-15-54 , for the credit of the ‘Martineau Society, Registered Charity No 1064092’,

Account No. 14082748,

on the . . . . . . . . . . . . . . . . . . . . . day of . . . . . . . . . . . . . . . . . . .20. . . . . .,

the sum of . . . . . . . . . . . . . . . . . .pounds . . . . . . . . . . . . . .pence ( £. . . . . . . )

and the same sum annually until cancelled in writing,

and debit my account No. . . . . . . . . . . . . . . . . . . . . accordingly.

Name and initials

Mr/ Mrs/ Miss/ Ms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Signature . . . . . . . . . . . . . . . . . . . . . .

 

When completed please return this form to:

Gaby Weiner, 27 East Street, Lewes, East Sussex BN7 2LJ, UK