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Would you kindly sign this Bankers Order and return to:                                           

Allan  Maitland, Membership Secretary, FREEPOST LON 17071  LONDON SW19 4YY

CLAN MAITLAND SOCIETY        CLAN REGISTRATION NO.___________

                I wish to become a member of the Clan Maitland Society and undertake to abide by its constitution.

                I enclose my cheque in settlement of the non-recurring REGISTRATION FEE of £12 and my Bankers Order for the ANNUAL SUBSCRIPTION (currently fixed at £15 sterling) payable now and renewable annually to.

 

Signed..................................... Name & Style (caps)....................................................

 

Address (to which the Yearbook should be sent)

 

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

 

..................................................Post Code........................................Date............................

 

New members are advised of their registration number upon acceptance.

 

STANDING ORDER MANDATE

 

TO..................................................... Bank                           Clan Registration No________

 

Address..........................................................................

 

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

 

..................................................... Post  Code.........................

 

 

 

 

 

 

Bank

Branch Title

 

Sorting Code Number

Please pay

Barclays Bank Plc

Bayswater Branch, Portman Square Group

20-69-17

 

                   Beneficiary's Name

Account Number

for the credit of

Clan Maitland Society

80294411

 

Amount in figures

              Amount in words

the sum of

£15

   Fifteen pounds

 

Date and amount of first payment

Due date and frequency

 

Now

£15

and thereafter every

12 months

quoting the reference

REGISTRATION NO:

 

until you receive further notice from me/us in writing and debit my/our account accordingly

 

PLEASE CANCEL ANY PREVIOUS STANDING ORDER OR DIRECT DEBIT IN FAVOUR OF THE BENEFICIARY NAMED ABOVE, UNDER THIS REFERENCE

 

SPECIAL INSTRUCTIONS

 

 

 

ACCOUNT TO BE DEBITED

 

ACCOUNT NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE________________________________________________________

 

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