Please print out and complete this form then send it together with the joining form to:
CPRW, FREEPOST, Ty Gwyn, 31 High Street, Welshpool, Powys SY21 7YD
Banker's Order |
To: (name of bank):...................................................................................... |
Address:..................................................................................................... ................................................................................................................. ................................................................................................................. Post Code:.............................................. |
Your Bank Account No. ................................................Sort Code:.................... |
Please pay now and thereafter annually on the same date, the sum of £................ to the credit of the Campaign for Rural Wales at |
Your signature........................................................................ date..................... |
Your Name: ................................................................................................. Your Address............................................................................................... ................................................................................................................. ............................................................Post Code........................................ |
| (to be completed by CPRW)
To the Bank: |