South East Welsh Springer Spaniel Club  

Bankers Order

Please complete this form, print it out, and send in with your application.

 

To: The Manager

Name of Bank plc

Address 1    Address 2                         

Address 3    Address 4

Post Code                      

 

Please pay to the South Eastern Welsh Springer Spaniel Club,

At HSBC, 87 High Street, Gillingham, Kent,  ME7 1BP

Sort Code: 40-22-35   Account Number: 31107100

 

The sum of:  Initially  Commencing Date:      

 

And on the 1st January each year thereafter until further notice.

Remember the £1.00 Joining Fee is a one off only Payment

 

Print Name        
                     First Name                     Surname

Address 1    Address 2                         

Address 3    Address 4

Post Code

                                               

 

Please debit my account number        Sort Code: 

 

Signed_____________________________________