Le Rocquier School PTA 100 Club 2019/2020 Standing Order request

To       …………………………………………………………………………………………... (your Bank’s Name)

            ……………………………………………………………………………………………(your Bank’s Address)

            ……………………………………………………………………………………………

            ……………………………………………………………………………………………

Dear Bank Manager, please set up a standing order as follows:

Debit my account (Name):                           ……………………………………………………………………

at                     (Bank): ……………………………………………………………..(Sort code):   ……………….

                        (Account number):    ……………………………………………………………………

with the sum of:   £     .00 (                                               pounds) annually

starting on:           *30th September 2019 (and annually thereafter)

                             [ * or immediately upon receipt of this instruction if after that date ]

for the credit of:   Le Rocquier School PTA

account number:  61434977

at:                           HSBC Bank Plc

sort code:              40-25-33

Quote Reference  100 Club

Signed:                    ………………………………………………………  Dated …………..……..........................

Print name:            ………………………………..…………………………………….............................................

Telephone number in case of query:           ……………………..…………………………………………….

Please post back Standing Order Form to:

100 Club Co-ordinator: Mrs. S Ennis, 41 Le Benefice, Le Marais, St Clement, Jersey JE2 6BF

THANK YOU FOR YOUR SUPPORT