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!!