Banker's Order.

To ......................................... Bank, ................................................................. Branch.

Sort code ....................................... Account Number ....................................................

Please pay into the account of the Regional Furniture Society held at Lloyds TSB Bank, Castle Street, Christchurch, Hants. Sort Code 30-92-02, Account Number 7739122 my annual subscription of £ ................ on 2 January in each year until further notice.

Please cancel any existing Banker's Orders made in favour of the Regional Furniture Society.

Signed .......................................................................................

Print Name ................................................................................

Print Address ...................................................................................................................

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

Date ................................................

Notes:

1. Top line - please fill in your Bank details.

2. Return this form to your bank as soon as possible.