SOUTH WEST VETERAN’S ATHLETICS CLUB

STANDING ORDER MANDATE

Please complete the form and pass it to your Bank or Building society

Your Details

Full Name____________________ Sort Code_____________

Account Number___________

Our Details

Payment Reference (SWVAC Membership No.) ________________

Bank: Lloyds TSB

Sort Code: 30-92-02

Account No: 02802284

Amount: £10 / £15 Amount in words: ________________

(Delete as appropriate)

Date of first payment: ____ April 20___

Frequency: Yearly until further notice.

Signed: __________________ Dated; _______________

If the amounts to be paid or the payment date change the SWVAC will notify you at least 10 working days in advance of your account being debited.

You can cancel this Standing Order at any time by writing to your Bank or Building Society. Please send a copy to us.