Newtonhill & District Village Association

200 Club

Please complete, print and return the form to:
 Melanie Torrance, 48 St Michaels Road
  Newtonhill,
 

 I would like to join the 200 Club, starting

  NAME: TEL No.

  ADDRESS:

  Please allocate me numbers at an annual cost of £12 each

  I enclose: Cash£    OR   Cheque £ made payable to "NVA 200 Club"

 OR

  I wish to pay by standing order and have completed the bank mandate below (please tick)

  ------------------------------------------------------------------------------------------------------
  TO:

  Bank    

  Address

  Sort Code Account number

  Account Name

 Please pay, beginning

  monthly the sum of  £ 1
  OR                                         (please tick)
  annually the sum of £12

  to Bank of Scotland, Tullos Branch, Sort Code 80-12-06
  for the credit of account no. 00626027 quoting Newtonhill Village Association 200 Club

  Signed ______________________________ Date