The Derbyshire Ornithological Society

 


STANDING ORDER MANDATE
Bankers Order
Name of your bank
Address of your bank


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Please pay immediately on receipt of this instruction and thereafter annually on 1st January, commencing 1st January 2013, the sum of £12.00 to:

                                       

                                       

                                       

DOS use leave blank
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Gift Aid
I should like the Derbyshire Ornithological Society to reclaim tax on all my subscriptions/donations since April 2000 and on all future subscriptions and donations
I am not a tax-payer
Sign and date

 

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Print the form, complete, sign, date and then send with your cheque to:

DOS Membership Secretary

B Staley
20 Lancelot Drive
Stretton
Burton-on-Trent
Staffordshire
DE13 0GJ

 
UK Registerd Charity No. 502422
Iteration: Heron
Iteration      Silouette
DOS

Derbyshire
Ornithological
Society