APPLICATION FOR MEMBERSHIP OF THE FIELD GUNNERS ASSOCIATION
Please complete and forward to:
148 Highland Road
Tel: 023 92 753897
E Mail: Peters.email@example.com
Surname Initials .. First Name ..
Partners First Name
Address where you would like correspondence sent: Telephone No .
Mobile No ..
Please complete all details and send both sections of the form to the above address
The Manager . Bank Plc Name of Account to be debited
. Account No
. Sort Code ...
Please Pay To: HALIFAX BUILDING SOCIETY
175 177 Commercial Road
For the Credit of: The Field Gunners Association:
Sort Code 11 06 15 Account No 00771634
The Sum of £10 immediately and subsequently £10 on the 1st January each year thereafter, crediting the above account until you receive further notice in writing from me/us, and debit my/our account accordingly.
SIGNATURE . SIGNATURE ..
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