Monthly Sponsorship

ARDINGLY OLD JESHWANG ASSOCIATION

Standing Order and Gift Aid e-form

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Thank you for wanting to become a Monthly Sponsor. Please fill out this form. Upon submission it will create a request for a monthly standing order to be set up in favour of Ardingly Old Jeshwang Association and the Chairman will be in touch.
Standing Order
To: The Manager
My bank*
My bank address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Please pay to Barclays Bank, Haywards Heath Branch, 77 South Road, Haywards Heath, West Sussex, RH16 4LB.

1. Sort Code: 20-49-76.

2. Account: 10605069.

3. Credit Ardingly Old Jeshwang Association
4. The sum of*

£20 - path lab technician£30 - nurse£80 - midwife£10 - nourishment£10 - iron tablets£50 - electricity£5 - generator campaignOther
Starting on*

DayMonthYear
and on the same day each month, until further notice.

5. Barclays Bank Reference: 20-49-76 10605069 (BACS Field 10)

6. Ardingly Old Jeshwang Association (BACS Field 11)
7. My bank account number*
8 digits only
My sort code*
6 digits only
8. Account in the name of*

PrefixFirst NameLast Name
9. My email address*

Confirmation Email
10. My telephone number
11. My address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
12. Signed*

Clear
Use your mouse to sign
13. Date and time*

DayMonthYearHourMinutes
Gift Aid
I would like the Ardingly Old Jeshwang Association (registered charity in England and Wales - 1024627) to reclaim tax on any donations or membership subscriptions that I have made since the date on this form, and for any future gifts I make. I have paid an amount of UK Income Tax or Capital Gains Tax equal to any tax claimed.
Answer

YesNo
Full name

PrefixFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Signed

Clear
Use your mouse to sign
Date and time

DayMonthYearHourMinutes
Enter the message as it's shown*
Should be Empty:

ARDINGLY OLD JESHWANG ASSOCIATION