Better Bedford - Membership Application Form

Bankers Standing Order

Please pay to : Better Bedford

Account Number: 88439453 - Sort Code: 60-02-13

National Westminster Bank plc
81 High Street, Bedford, MK40 1YN

A Monthly sum of: (tick box)

£2.50 £5 £10 Other (enter amount)

A Quarterly sum of: (tick box)

£15 £20 £30 Other (enter amount)

A Yearly sum of: (tick box)

£30 £60 £120 Other (enter amount)

on (date) until further notice

___________________________________________

Click to Print This Page

On completion of this form, please print, sign and return to

Acting Membership Secretary, Better Bedford,
3 Brereton Road, Bedford  MK40 1HU. (Telephone 01234 262505).

Data Protection Act 1998
Better Bedford undertakes not to pass this information to any other person or organisation