Bank Standing Order
 
To the Manager
 Bank Plc
Address
 
Your bank's sort code
Your account number to be debited
 
Please pay Barclays Bank (20-96-96) Wimborne Branch,
6 The Square, Wimborne, Dorset. BH21 1JB
to the credit of Pramacare (A/c No. 10724033) the sum of
 
£ (figures)
(words) pounds
 
On the day of
 
and the same amount on the same day each until further notice
 
Signed*
Date
*please complete this field in black / blue ink after you have printed off the form
Name
Address
Postcode
This cancels my existing bank standing order in favour of Pramacare.
 
If you pay tax, by signing the Gift Aid Declaration Form, we will be able to claim back the tax on this donation and every donation after this.
 
Moran House, 1 Holes Bay Park, Sterte Avenue West, Poole, Dorset BH15 2AA. Tel. 01202 207300