Sharing the Caring - St Peter's Hospice Standing Order Form

Sharing the Caring

BANK STANDING ORDER

S/C REG00A

Your Name:

(BLOCK CAPITALS please, including Mr / Mrs / Ms / Miss or Title)

Your Address:

Postcode:

Telephone Number (in case of query):

Please pay St. Peter's Hospice:

each:

Month / Quarter / Year
(Delete as applicable)

From my account until further notice starting on:

Enter Date - Month - Year in boxes e.g.

Bank Name:

Bank Address:

Postcode:

Account Number:

Sort Code:

Your Signature

This cancels all existing Bankers Orders to St Peter's Hospice

Yes / No
(Delete as applicable)

For Office Use:

Please pay to National Westminster Bank Plc. PO Box 238, 32 Corn Street, Bristol. BS99 7UG

(Sort Code 56-00-05) crediting St Peter's Hospice Account Number. 01009648.

Please Quote our reference

Please return your completed form to:

The Fundraising Office, St Peters Hospice, 58 Royal York Crescent, Clifton, Bristol BS8 4JP

Download MS Word Version

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