Rusper Church 200 Club

Promoter:

Martin Morris

Old Park Farm

Rusper

RH12 4QT

APPLICATION TO JOIN

I would like to become a member of the Rusper Church 200 Club by buying   __ share/s at £5 each per month/£55 per annum

Name       Tel: _________________________

Address  

Signature      Date  

A share certificate and a full copy of the rules will be sent to you.

To assist in administration, monthly payment will be by standing order. This of course can be cancelled or amended at any time*.

Annual payments, which attract a £5 discount i.e. £55 per share, can be made by standing order (preferred method), cheque or cash.

Please complete the attached standing order mandate and hand it to your contact or send it to The Administrator, Rusper Church 200 Club, Elsinoro, Horsham Road, Rusper, Horsham RH12 4PR who will forward it to the bank.

*After minimum contract period of 12months

  STANDING ORDER MANDATE (Please do not detach)

To  _________________________________________ Bank/Building Society

Address  

    Postcode  

Please pay Lloyds Bank plc, Horsham, Sort Code 30-94-41 for the credit of Rusper Church 200 Club, Account No: Ref:   the sum of £   per month/annum commencing _____________and thereafter until cancelled by me in writing.

My Bank Sort Code    -     -     My Bank Account No ___________________

Signed ________________  Name_________________   Date _________