HAMPSHIRE ORNITHOLOGICAL SOCIETY

Bank Standing Order

Date............................

To............................................................Bank

Address...........................................................

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Please pay to Lloyds Bank Plc, 4 Castle Street, Christchurch, Dorset, BH23 1DU

(sort code 30-92-02) on 2nd January annually, the sum of £12.00 (twelve pounds) until

further notice, for the credit of

HAMPSHIRE ORNITHOLOGICAL SOCIETY (Account No. 01182908).

This cancels any order at present operating in favour of the Society.

SIGNED.......................................................

Account No. ................................................

Member's Name and Address

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Please send this form directly to your bank

HOS is a registered charity