STANDING ORDER MANDATE   

   

Please complete this form in BLOCK CAPITALS   

   

To………………………...…………………………………………………Bank   

      

Sort  Code   ......................................... 

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…………………….……………………………………………………………………  Branch   

                                                                                      

 

Account Name…………………………………..................................                REFERENCE  …………………….

                                                                                                            (To be the name of the class you attend)   

 

Account No. .............................................................................  

   

Tel No: …………………………………….. 

     

Please set up the following Standing Order and debit my/our account accordingly   

   

 Pay – Helen Baker-Pawling    

 Bank – Starling Bank

 Account Number - 41736793

 Sort Code – 60-83-71   

        

    

 Amount of payment:   £28 (TWENTY EIGHT POUNDS ONLY)      

   

TO BE PAID MONTHLY on the ……1ST………

    

 Commencing FROM        _____ /____/______      

    

 UNTIL FURTHER NOTICE   

  

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Signature_______________________________________Date_____/____/_____