Chichester High School for Girls : Pledge 10 Club membership Form

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Pledge 10 Club membership Form

Pledge 10 club Membership Form

Name: ...........................................................................................

Address: ..........................................................................................

........................................................................................................

Tel Number: ..................................

Email: .........................................

Name and form of daughter(s) at CHSG....................................................

Please complete either part A or B

Part A

Cash or cheque

I enclose cash/cheque (payable to CHSG PTA for the sum of £10

........................................................................................................

Part B

Standing Order

Bank..........................................Sort Code..........................................

Branch.......................................Account No........................................

Account Holders Name.........................................................................

I hereby authorise payment of £10 on 3 September 200.... (or as soon as possible) and annually thereafter until cancelled by me, to CHSG PTA at Barclays Bank, Chichester, (20-20-62), A/C Number 20715352

Signature......................................... Date................................