Please print this form
BANKER’S ORDER
To……………………………………BANK
Address…………………………………………………………………………
………………………………………………………………………………….
Post Code…………………
Please pay annually on January 1st to Lloyds TSB, Tenbury Wells, Sort Code 30-98-52 for the credit of St Michael’s College Society, Account No 00114729, the sum of £…………… until you receive further notice from me in writing.
My Name ………………………………
Address…………………………………………………………………………
………………………………………………………………………………….
Post Code………………
Name of Account to be Debited ………………..........
Account Number ………………
Sort code: ……………
Signed ……………… Date …………
Years at SMC: 19__ to 19__
or Year elected Friend of the Society:_________
NOTES
Minimum Subscription £10 (more if you would like)
Subscriptions are only payable by Members and elected Friends
Please return this form to:
Dr John Pepper
SMC Treasurer
Gelda Lodge
Sandford Avenue
Church Stretton, Shropshire
SY6 7AE v2.0/2008