Membership Form PDF Print E-mail
To the manager of my bank listed below, please set up the following standing order:
 
My Name
 
My address                                     
 
 
 
 
My contact telephone number
 
My bank
 
My branch
 
My sort code
 
 
 
 
 
 
My account number
 
 
 
 
 
 
 
 
 
Please set up a standing order as follows:
 
Recipients name
North of England Otolaryngological Society
 
Bank
Lloyds TSB, Park Row, Leeds
 
Account number
00400916
Sort code
30-00-05
 
Payment                    First payment date               How often payment made
£50                             1st next month                     Yearly
                                                                                    Until
                                                                                    Further notice
 
                                   
Signed          
 
 
Date