Clubs & Organisations

East Linton 200 Club

Application Form for Membership

 NAME              ……………………………………….

ADDRESS            ………………………………………. 

……………………………………….……………………………………………………………………………………………………   

TEL.                 ……………………………………………………………

Number of memberships / chances required    (Please Tick) :

Each chance = £5

1
2
3
Other

 I apply to join the East Linton and District Community Association 200 Club. I agree to abide by the Rules and Regulations of the Club.

Signature(s)……….........…..…………..            Date……...……

Please fill in the Standing Order Mandate below and return it with the completed application form to :-

Liz Ingram, East Linton 200 Club Promoter

Sunny Cottage, Walker Terrace, East Linton, EH40 3AL

 ---------------------------------------------------------------------------------------------------------------------------------

STANDING ORDER MANDATE
To : ____________________________________________ Bank

Postal Address: _______________________________________________________________________________ 

	Bank			Branch Title				Sorting Code No.
Please Pay	Bank of Scotland			Head Office, The Mound Edinburgh				80 - 20 - 00
	Beneficiary’s Name					Account No.		Quoting Ref.
For the credit of	East Linton 200 Club					00348358
	Amount	Amount in words
	£
	Date of first payment				Due date and frequency
Commencing	13th		And thereafter every		13th Monthly

PLEASE CANCEL ALL PREVIOUS STANDING ORDER MANDATES IN FAVOUR OF EAST LINTON 200 CLUB

Account to be debited	Sort Code & Account Number

Signature(s)            ………………………………… Date ………………