Request for Payments by Standing Order

 To: The Manager

Your Bank’s Name       __________________________________

Your Bank’s Address   __________________________________

                                       __________________________________

                                      __________________________________

Your Bank Account Number           _____________________

Your Sort Code                               ____-____-____

 Please make a payment of £_____ monthly on the ___

day of each month starting from _____________, until further

notice to the following account:-

Quoting Reference:  _______________ (Child’s Name or GIFT)

HSBC Bank plc, Bedford Square, Tavistock, Devon PL19 0AH

Account Number          61461559

Sort Code                     40-44-05

Account Name              Word in Action Outreach UK

This replaces any existing STO to WIAO UK.

Signed: ………………………………………      Date:      /      /

Name: ………………………………………..

Address: ……………………………………………………………………………..