250 Club 3 of 3

3. 250 CLUB STANDING ORDER MANDATE


To become a member of the 250 Club, please complete and return the Standing Order mandate to:

David H. Gilbert, Club Administrator, 6, Kenilworth Avenue, Handforth, Wilmslow, Cheshire. SK9 3DP

STANDING ORDER MANDATE

To____________________________________________Bank plc

Branch ________________________________________

Address______________________________________________________________

Please pay £_______ on the 1st day of each month, commencing on ______________
until further notice, or until cancelled in writing by me, for credit of the following:

Bank / Branch: Royal Bank of Scotland, Grove Lane, Wilmslow, Cheshire.

Sort Code: 16 34 24

Credit Account: Grove Park 250 Club

Account Number: 10119690

Quoting Reference _____________________ (Your Account Name)

Please debit my account with yourselves, as quoted below:

Account Number:___________________Name:______________________________

Address / Post Code:____________________________________________________

Telephone number:___________________Signature of Account Holder__________________