“FRIENDS OF ST DAVIDS”	Standing Order Request

I/We wish to pay an annual subscription by standing order to 
become a “Friend/Friends of St.David’s”, and authorize payment 
as detailed below to the general deposit account of 
“St.David’s Church” held at Lloyds TSB Bank PLC,      
5, Windsor Road, Neath. SA11 1LS. 
Sorting Code: 30-95-86 Account No: 7179747

Name………………………………………………………………………
Address…………………………………………………………………..
……………………………………………………………………………...
Post Code………………………………
Telephone Number………………………………………………….
Email Address………………………………………………………..

Bank Account Number ………………………………………….
Title of Account ……………………………………………………
Sort Code Number …………………………………………….
Amount to be paid £10.00 / £15.00 * Please delete as appropriate
Other amount__________
Payment date ………………………………… and once a year on the same date 
thereafter until countermanded by me/us. 

Signed ………………………………………………	Dated ……………………….

To:-  (Please insert address of bank) 
The Manager 						
(Ref No:		)
…………….........................			Bank Use only
…………………………………
…………………………………
…………………………………

Please return completed form to:

“Friends of St David’s” c/o 14, Cimla Road, Neath, SA11 3PP