THE BUD CLUB

a part of the BUD FLANAGAN LEUKAEMIA FUND

Registered Charity number 1092540

General Secretary:

I wish to join The Bud Club

Name: ..........................................................................................

Address: ..........................................................................................

..........................................................................................

Telephone: ..........................................................................................

Membership No. ........................

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STANDING ORDER MANDATE

 

To ............................................................................ Bank Plc

Address: ...........................................................................................

...........................................................................................

Please pay: BARCLAYS BANK PLC

27 SOHO SQUARE, LONDON, W1A 4WA SORT CODE 20-05-75

For the Credit of: The Bud Club

Account number 20220027

The Sum of 15 (fifteen pounds)

Commencing Now and hereafter each year on ...... day of .....................

Quoting reference ......................

Debiting the following account:

Name of account ............................................................................

Account number ............................................................................

Sort Code .........................

Signatures(s) ............................................................................