Standing order mandate
To the manager
Name of Bank
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please pay -
Lloyds Bank plc, 16 Gentlemans Walk Norwich, NR2 1LZ
For the credit of -
Guide Association Anglia Region, Sort code - 30-96-17, Account Number 01735700
Please quote reference FoH and either your name or Friends' membership number
Please choose one of the following payment options:
£10 Individual subscription
£20 Group subscription
Please choose one of the following payment options:
I would like to pay monthly
I would like to pay annually
Name of account holder to be debited
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Last Name
Account number
Sort code
Please quote reference - FoH
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Date
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Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date of signature
Your name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Telephone Number
Format: +44 0000000000.
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All Friends of Hautbois receive regular newsletters giving updates and information about events and developments at Hautbois Activity Centre. Everyone also receives invitations to Friends only events.
Individual subscription
£10.00 per year
Group subscription
£20.00 per year
Cheques should be made payable to 'Guides Association Anglia Region'.
Please send your payment together with your contact details using the form below (and on reverse if paying by Direct Debit) to:
Friends Subscriptions
Girlguiding Anglia
7 Great Hautbois Road
Coltishall
Norwich
NR12 7JN
Please choose one of the following payment options:
I would like to pay by cheque (please make cheques payable to 'Guide Association Anglia Region').
I would like to pay by standing order (please complete and return form on reverse).
Gift Aid Declaration - I want to gift aid my donation and any future donations I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every £1 that I give.
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Year
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