Please enter details as required:
| To: | ..................................................... | |
| Bank/Building Society | ||
| Address1 | ..................................................... | |
| Address2 | ..................................................... | |
| Town | ..................................................... | |
| Post Code | ..................................................... | |
| Please pay: | Bank of Scotland | |
| 10-16 King Edward Street | ||
| Perth | ||
| PH1 5UT | ||
| Sort Code | ||
| Account Name | Scone Tennis Club | |
| Current Account No: | ||
| The sum of | £ | |
| Amount in words: | ||
| Commencing first day of (enter month and year) | ................................................... |
And thereafter every MONTH/YEAR (delete as appropriate) until futher notice in writing and debit MY/OUR (delete as appropriate) account accordingly.
| Name of account to be debited: | ..................................................... | |
| Account no to be debited: | ..................................................... | |
| Sort code of bank to be debited: | ..................................................... | |
| Signed: | ..................................................... | |
| Dated: | ..................................................... |
Please return this part to :
| Please return this part to: | Ian Hunter | |
| Secretary of Scone LTC | ||
| 22 Needless Road | ||
| Perth | ||
| PH2 0LD |
Please enter your details below
| Your name: | ................................................... | |
| Your address 1: | ................................................... | |
| Your address 2: | ................................................... | |
| Your post code: | ................................................... | |
| Your Tel no: | ................................................... |
Method of Payment
Please indicate your selection below and state the month it is to take effect
| Monthly Standing Order of: | £2.....effective from:........................... | |
| Annual Standing Order of: | £24....effective from:........................... | |
| Annual Cash Subscription of: | £24....effective from:........................... | |
| Annual Subscription by Cheque of: | £24....effective from:........................... | |
| Your signature: | ....................................................... | |
| Date: | ....................................................... |