rollerski club - standing order form
Either use internet banking to set up your own regular payment to: Rollerski Instruction, A/C 61604937 Sort Code: 40-02-03 Or complete (print) the bankers order form:
To the Bank Manager (Name of Bank) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Branch Address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Postcode . . . . . . . . . . . . . . . . .
Sort Code .........-.........-......... Account No. . . . . . . . . . . . . . . . . . . . .
Please pay Rollerski Instruction (rollerski club)
£ 25 / 35 / 37.50 / 52.50 every month (delete as applicable, £25 if you use your own equipment and £35 if you need to borrow our equipment, for just one venue; £37.50 and £52.50 if you go regularly to both venues).
Start on ...../...../..... (date) until further notice.
Name (Mr/Ms/Mrs/Miss/Dr). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Signature . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Postcode. . . . . . . . . . . . . . . . . . . .
FOR BANK USE: Please use our ref: A/C 61604937 Sort Code: 40-02-03
Please send this to your bank, with instructions to set up this standing order.
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