Standing order form – Ekklesia partnership

Please print this page (click on the ‘printer friendly version’ option at the bottom right of this page) then fill out and send this form to:-

To the Manager …………………………………………………………………. Bank

Address:…………………………………………………………………………………..

………………………………………………………………………………………………

………………………………………….. Post code:…………………………………..

Please debit my account (name) ……………………………………………………

(number) ………………………………………………………………………………….

and credit National Westminster Bank, Streatham Branch, sort code 60-20-39

for the account of Ekklesia, account numer 42525527

the sum of £5 on ………………………(insert date of first payment),

and the same sum on the same date of each month thereafter.

Signed:………………………………………………………………………………….

Dated:…………………………………………………………………………………..

Full name:……………………………………………………………………………..

Address:……………………………………………………………………………….

…………………………………………………………………………………………..

…………………………………………………………………………………………..

Post code:………………………….. Email:………………………………………