Please print out and complete the following form
BANKERS ORDER FORM
To: The Manager
.....................................................................................................Bank Ltd
.....................................................................................................................
.....................................................................................................................
(Please insert the Bank's full address)
Please pay to Barclays Bank plc, Cheetham, Manchester, Sort Code 20-54-58
for the credit of Animals in Distress (Account No. 40293393)
the sum of £............................. on the ......................................................... day of
..............................................year of .................................. and the same payment
annually on the ........................................... day of .................................................
until further notice, quoting reference No. ...........................................................
(please leave blank)
Signature: ..............................................................................
Name: .....................................................................................
Address: ................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
Please return to:-
ANIMALS IN DISTRESS, 55 Silver Street, Irlam, Manchester, M44 6HT
registered as a charity under the Charities Act 1960 No. 515886