STANDING ORDER FORM
Please complete this standing order form, print and send to:
mediawatch-uk, 3 Willow House, Kennington Road, Ashford, Kent, TN24 0NR
Standing Order Form
If you prefer to pay your annual subscription (and any donation)
by Standing Order please complete this section:
Bank Details
To: The Manager, Customer Accounts,
BANK/BUILDING SOCIETY:
ADDRESS:
TOWN:
POSTCODE:
Payment Details
Please pay mediawatch-uk the sum of £ annually, starting on the first day of (month) (year) until further notice.
Account Details
Account Number:
Account Name:
Sort Code:
--
Your signature:
Note to Bank/Building Society:
Please pay the above sum to mediawatch-uk:
| Bank: |
Alliance & Leicester Girobank plc, Bootle, GIR 0AA |
| Account Name: |
mediawatch-uk |
| Account Number: |
0027 8703 |
| Sort Code: |
72-00-02 |
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