Standing Order for Membership subs

* To:                                                                                                                    

Dear Sir

New Standing Order Mandate

My/Our Name:                       _______________________________________________

(to appear on the SWRA’s statement)

My Account Number:             _______________________________

My Sort Code:                         ______ – _______ – ______

Please set up a new standing order mandate from the above account to pay the following beneficiary:

            Beneficiary:                                South Western Rottweiler Association (“SWRA”)

            Beneficiary Sorting Code:          52-10-42

            Beneficiary Account Number:    20109679

            Amount:                                      £10     OR     £12 a YEAR

    (please cross out incorrect amount)

            Due:                                             01^st January (annually)

            Until:                                           Until Further Notice

Should you have any questions, please do not hesitate to contact me.

Yours faithfully

_______________________________                                  _____________________

Signature                                                                                 Date   

* Please insert the name and address of your own bank, and then post the form directly to them or Nikki Marker, Trefor Cottage, Shute Lane, Pensilva, LISKEARD, PL14 5QD