AS THIS FORM REQUIRES YOUR SIGNATURE YOU SHOULD PRINT IT OFF AND SEND TO ADDRESS AT THE BOTTOM
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CONTESSA 32 CLASS
BANK STANDING ORDER FOR ANNUAL SUBSCRIPTION

Please pay IMMEDIATELY and then on 2 JANUARY each year the sum of £20 (Twenty) for credit to:

Account no: 2111703           CONTESSA 32 CLASS             Sort code: 30-91-11
LLOYDS BANK plc
10 HIGH STREET
BRACKNELL
BERKSHIRE  RG12 1BT

Charging such payments to my/our account until this order is cancelled or amended by me/us in writing.

Account Name :   ________________   Account Number:  ____________

Signed: ______________________     Date:  ___________

PERSONAL DETAILS

Full Name and Title: _________________________________________

Address:        _______________________________________________

_________________________ Post Code: ______

Preferred Tel. No:  _______________________  e-mail ___________________  @__________________

Boat Name: ________________________      Sail No: ___________  Normal Port:  _________________

Date Purchased: ____________          Purchased from:   ______________

Sole owner / Part owner /  Crew (Delete as appropriate)

PLEASE RETURN THIS FORM TO:

Rupert PARSON
Flat 1
62 Clapham Common Southside
LONDON
SW4 9DA                             Telephone:   07747 802414