![]() | GWENT BACH SOCIETY | |
| PRESIDENT: Dr. Roy Massey | FOUNDER:
Dr. Lloyd Davies | |
MUSICAL
DIRECTOR: Roger Langford | ||
Associate Member's Subscription 2005 - 2006 | ||
Names | ||
Address | ||
Postcode |
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Telephone
Number (Including code) |
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Email | ||
I
enclose | a) A cheque for £17.50 payable to Gwent Bach Society | |
or | b) The completed standing order form below | |
STANDING
ORDER MANDATE | ||
To:
Bank / Building Society | ||
Address
of Bank / Building Society: | ||
Account
Names: | ||
Account
Number: | ||
Sort
Code | ................ / ................ / ................ | |
Please pay Lloyds Bank Plc (30-90-02), Abergavenny, for the credit of Gwent Bach Society, Account Number 00018083, the sum of £17.50 (Seventeen Pounds and Fifty Pence only) on the 6th April 2004 and thereafter every 6th April annually until further notice. This instruction cancels any previous order in favour of the beneficiary named above.
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Signature | ........................................................... Date.............................................. | |