Hampshire and the Islands Standing Order Form

To the Manager

Your Bank

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Address of Bank line 1

Address of Bank line 2

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Post code

Please pay to the account Number 00307572 of Hampshire & the Islands Historic Churches Trust
National Westminster Bank PLC (Code 55-81-26)
105 High Street, WINCHESTER, Hants. SO23 9AW

The sum of (amount in words) …………………………………………………………….( £ …………………..)

On ……/……./……./ and on that date annually, until I cancel this Mandate,

please debit my account no.

Title

First name

Surname

Address line 1

Address line 2

Town or City

Post code

email

 

Signed…………………………………………………………………………………………. Today’s date…………………………………………...

 

Please return this form entire to: Mr G.B. Hughes, Gift Aid Secretary, 75, Downlands Way, South Wonston, Winchester, SO21 3HS