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Membership Application Form
I apply for membership of the:-
"Friends of Halsway Manor 200 Club"
I have read and agree to abide by the rules and regulations.
Name: ..............................................
Address: ......................................................
......................................................................
......................................................................
Postcode: ...................
Telephone: .......................................
Subscription:-
Membership(s) ......... at £12.00 per annum
Total: £ ............
Payment method:-
i. Banker’s Order (preferred - see over)
ii. Cheque
(please delete as appropriate)
Cheques to be made payable to:-
"Friends of Halsway Manor 200 Club"
Signed: .............................................
Date: ................................................
Please send to:-
Mr P. Hopwood (Treasurer)
The Acorns, Axford Road, Ellisfield, Basingstoke, Hants RG25 2QG
Telephone: 01256-381321
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Banker's Standing Order
To: The Manager
Name and Address of your bank:-
......................................................................
......................................................................
......................................................................
Branch Sort Code: ......................................
Please pay to:-
"Friends of Halsway Manor 200 Club"
Account Number 2603810
Lloyds Bank PLC (30-90-09)
115 Victoria Road
Aldershot
Hants GU11 1JQ
The sum of £.......... per annum starting on:-
1st day of ........................... 20 ......
until further notice.
Name: ..............................................
Account Number: ........................................
Address: ......................................................
......................................................................
......................................................................
Postcode: ...................
Telephone: .......................................
Signed: .............................................
Date: ................................................
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