Association of Government Veterinarians
To: The Manager
Bank Name:.......................................................................................
Address of Bank.................................................................................
Post Code:........................................................................................
Account Name:.........................................................................
Account number: .....................................................................
Sort code:........................................
Please pay to Barclays Bank plc, Surbiton Branch, Kingston-upon-Thames Business Centre, 6 Clarence Street, Kingston-upon-Thames, Surrey. KT1 1NY ( 20 - 46 - 73 ) for the account of The Association of
Government Veterinarians ( Account No. 20122572 ) the sum of £25 (Twenty five pounds) on the first day of May each year unless otherwise notified.
Please cancel any previous standing orders payable to account 20122572.
(BLOCK CAPITALS PLEASE)
NAME: ..............................................................
Signature:............................................
Date: ...................................................
ADDRESS:
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................