*PLEASE SEND THIS FORM DIRECT TO YOUR BANK*

STANDING ORDER MANDATE

To: ________________________________________________________________ BANK plc

Address:-

_____________________________________________________________________ Branch

___________________________________________________________________________

Account No:- [  ] [  ] [  ] [  ] [  ] [  ] [  ] [  ]  Sort Code:- [    ] [    ] [    ] 

Name (s) ___________________________________________________________________

___________________________________________________________________________

Please debit my/our account the sum of £ ________ per month, starting

______________(day) ______________(month) ______________(year)

and every month thereafter until you receive further notice in writing

Payment to:- Barclays Bank, 60 Union Street, Bristol

Sort code:- 20-13-42

Account no:- 60737682

Account name:- Maji Safi School

 

Signature(s) __________________________________   Date __________

 

                     __________________________________