STANDING ORDER MANDATE

We welcome payment by annual standing order. Please fill in this mandate and return it to the SPJARA membership secretary Jonathan Moffitt with your membership form.
 
Your account details:
     
Your Bank/Building Society Name and Address:
 
Postcode:
Name of account holder:
Account number:
Sort code:
 
Instruction to bank: Please set up the following standing order payable to St Philip & St James (Leckhampton) Area Residents’ Association and debit my account accordingly.
 
SPJARA
Bank: Lloyds TSB
Sort code:  30-90-54              
Account no.:  04684759         
 
Reference:                  [Your full name]
 
Regular amount:         [£5.00 for one, £7.50 for two at same address]
Date of first payment:
Frequency:                  Annually
Expiry date:                 Until further notice/ or [insert date]                            
 
I/we authorise you to debit my/our account in accordance with the standing order instructions above
 
            Name:
 
            Signature:
 
            Date:
 
Please print off and return the above form to the SPJARA membership secretary Jonathan Moffitt,  35 Gratton Rd Cheltenham GL50 2BT