THE HENRY WILLIAMSON SOCIETY

Banker’s Order for Subscription Payment
To:

Bank   

Please fill in the name and address of your bank.
Address:  
     
     
Please pay: LLOYDS TSB, 234 HIGH STREET, EXETER, CODE 30-93-14 the sum of £                        and debit my/our account No                                  for the credit of THE HENRY WILLIAMSON SOCIETY Account No 3532081. (Bank) Please quote this reference number                                                  .
The first payment to be made on the 15th September 2006 and subsequently on the same date annually thereafter unless cancelled.

THIS AUTHORITY CANCELS ANY EXISTING ORDER IN FAVOUR OF THE HENRY WILLIAMSON SOCIETY
Name: (Block Capitals)

 
Address:  
     Signed:   

Postcode:  

 Date:   

PLEASE RETURN COMPLETED BANKER'S ORDER TO THE MEMBERSHIP SECRETARY:  MARGARET MURPHY (MRS), 16 DORAN DRIVE, REDHILL, SURREY, RH1 6AX (NOT YOUR BANK).

The reference number above will be filled in by the membership secretary.

Please note that the subscription rates are: 

   General Member £12.00 p.a.
  Family members £15.00 p.a.

Members in overseas countries (except EEC) please add £2.00

 

 

PLEASE PRINT OUT, FILL IN, AND RETURN THIS FORM