Registered Charity no: 291319

Annual Subscription Standing Order Form

Your Bank Details

Name of Bank


Address



Sort Code:


Account Name(s):


Account No:


Please pay the following Standing Order on 1st April annually

Bank:

HSBC

Barras Street

Liskeard

Cornwall PL14 6AE

Sort Code:

40-28-22

Account Name:

South West Early Music Forum

Account No:

91477285

Amount (please delete as appropriate)

Individual: £8.00

Family: £10.50

Under 18: £5.00

Institution: £8.00


This mandate cancels all previous mandates to the same Payee under the same reference.


Signature:





Date:

Please send the completed form directly to your bank