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TO: The Manager
BANK NAME:
BANK ADDRESS (inc. postcode):
My INSTRUCTIONS: Please Debit my account in accordance with the following:
Payee: WHITSTABLE RUGBY CLUB
ACCOUNT No: 00407065
SORT CODE : 30-99-61
BANK : Lloyds Bank
ADDRESS: 14 High Street
Whitstable
Kent
CT5 1BH
AMOUNT (multiples of £2.50): £
AMOUNT IN WORDS:
FIRST PAYMENT and FREQUENCY: 1st...........201... and 1st day of each month thereafter until further notice.
MY REFERENCE:
TERMS: This debit instruction should continue to run with my account debited on the month denoted until such time as you receive a written cancellation notice from me.
ACCOUNT HOLDER DETAILS:
NAME:
ACCOUNT NUMBER:
SORT CODE:
MY ADDRESS:
SIGNATURE:
DATE:
On completion please return this form to :
Jamie Kemp
The Hollies
Otterden Road
Eastling
Faversham
Kent
ME13 0BW