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PLEASE EITHER SET UP A STANDING ORDER DIRECT WITH YOUR BANK USING OUR ACCOUNT INFORMATION BELOW OR PRINT AND SEND TO DIRECTLY TO YOUR BANK, OR TO US AT: 10 Gibson Gardens, London N16 7HB
Bank plc:
Branch:
Address:
Date:
Name account held in:
Type of account:
Sort code:
Account number:
Amount of first payment: £
Amount of subsequent payments: £
Reference: House of Good Health
Date of first payment: First Day of
Date of subsequent Payments: First Day of Each Month and On-Going
(please delete if you would like to make a one off payment)
Made payable to: House of Good Health
Account number: 02579291
Sort code: 30-93-79
Lloyds TSB, Hammersmith Branch, 21 King Street, London W6 9HW
Signature:______________________________
NYUMBA YA THANZI THANKS YOU FOR YOUR GENEROSITY!!
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