Fleet Pond Society
(Founded 1976)
PATRON: Chris Packham
Charity No 290637
	
BANKERS ORDER FORM
(Please send to the Membership Secretary, not to your bankers) 
Send to: Kay Newby, 53, Wood Lane, Fleet, Hampshire GU51 3ED

To The Manager, (bank name)..................................................................

Bank address........................................................................................
 
........................................................................................................

.........................................................Postcode......................

Bank sort Code    _____  _____  _____

Please pay to Fleet Pond Society, Account No.  80378623 
at Barclays Bank plc., Fleet Branch, Sort Code 20-16-99

the amount of £............  annually

Starting on (date)...........................................................

And thereafter each year on the 1st. February until countermanded by me.

Debit my bank account number  ________________________________________

Signed.......................................................Date...................

Name(s).............................................................................

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

.......................................................................................

.......................................................................................

Annual subscription is £5.00 per year or £6.00 for postal members.
Subscription is £5.00 if you wish to receive your quarterly Newsletter by e-mail.
If you wish to receive the Newsletter by e-mail, please tick the box below and supply an e-mail address:

Please send my Newsletter by e-mail to:

E-mail........................................................................................


Caring for Fleet Pond Nature Reserve
Registered Charity No. 290637