BANKERS STANDING ORDER  - HAVANT RFC 250 CLUB

To : ___________________ Bank PLC      ___________________ Branch

Bank Address________________________________________________

Please pay the sum of £     quarterly / half yearly / yearly to GIROBANK PLC BOOTLE (Code 72- 00- 05) for the account of HAVANT RUGBY FOOTBALL CLUB - 250 Club, A/C Code 7- 561- 6709 commencing __________ . Please quote Membership No : __ . This authority cancels any existing authority in favour of Havant Rugby Club - 250 Club with this Membership No.

Name ______________________     Signed ____________________

Address ____________________    

Sort Code___________________   Account No ________________

Subscriptions are £6 quarterly, £12 half yearly and £24 yearly. This is the equivalent of £2 monthly.