Chaldon Animal

Sanctuary

Standing Order Authority

Name of your Bank...................................................... Branch Title.....................................................


Address of your Bank............................................................................................................................


                                       ...........................................................................................................................


                                       .................................................................. Post Code....................................


Your Account No.................................................................            Sort Code......................................


Please pay the sum of £.............. from the above account on the .............. day of each month / quarter / year  commencing ................................................. to: BARCLAYS BANK, 10 The Square, Caterham, Surrey. CR3 6XH  for the credit of CHALDON ANIMAL SANCTUARY.

ACCOUNT NO. 30497797 / SORT CODE NO. 20-24-64.


Name........................................................................................................................................................


Address...................................................................................................................................................


              ....................................................................................................................................................


              ............................................................................   Post Code..................................................


Signature(s)............................................................................................................................................


Print Name(s)......................................................                       ............................................................


Date.....................................................

(Please send this form to your Bank/Building Society and let us know that you have set this up)

Thank you - Your support is greatly appreciated!

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