Monthly Sponsorship

ARDINGLY OLD JESHWANG ASSOCIATION

Standing Order and Gift Aid e-form

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

City State / Province

Postal / Zip Code Country
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 campaign
Starting on *

Day Month Year
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 *

Prefix First Name Last Name
9. My email address *

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

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
12. Signed *

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

Day Month Year Hour Minutes
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

Yes No
Full name

Prefix First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Signed

Use your mouse to sign Clear
Date and time

Day Month Year Hour Minutes
Enter the message as it's shown *
Should be Empty:

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