JSPCA 100 CLUB
STANDING ORDER FORM
Mr/Mrs/Miss/Ms Surname:________________________________________________________
First Name: ___________________________________________________________________
Address: _____________________________________________________________________
_______________________________________________________________________________________
Post
Code: ___________
Please delete whichever one of these options is not applicable:
Please pay the sum of £24 on the 20th March 2009 and thereafter annually on 20th March to the account of the Jersey Society for the Prevention of cruelty to Animals (Inc), account number 20255183 at the Royal Bank of Scotland International, Bath Street, St Helier, Jersey (sort code 16-10-28)
Or, if joining post March 2009
Please pay the sum of £ (see joining options below) and thereafter £24 annually on 20th March to the account of the Jersey Society for the prevention of Cruelty to Animals (Inc), account number 20255183 at the Royal Bank of Scotland International, Bath Street, St Helier, Jersey (sort code 16-10-28).
Name of your bank: ____________________________________________________________
Branch address: ______________________________________________________________
__________________________________________________ Post code: _______________
Account name: _______________________________ Account number: ________________
Sort Code: _______________________
Signature: _______________________ Date: ______________________
Joining options:
| Join date | Amount to pay | Join date | Amount to pay |
| March | 24.00 | Sept | 12.00 |
| April | 22.00 | Oct | 10.00 |
| May | 20.00 | Nov | 8.00 |
| June | 18.00 | Dec | 6.00 |
| July | 16.00 | Jan | 4.00 |
| Aug | 14.00 | Feb | 2.00 |
PLEASE RETURN THIS FORM TO THE JSPCA AND NOT TO YOUR BANK
If you wish to pay your 100 Club membership by cheque, please make this payable to the JSPCA. I enclose a cheque for £ ________________.
THANK YOU FOR YOUR SUPPORT