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Join the Open Rights Group
Please complete and return this standing order form to:
Open Rights Group, 12 Duke's Road, London WC1H 9AD
Your details:
Name: Salutation (Mr/Ms/Dr/etc)
Address:
Postcode:
Email:
Making a regular contribution is the best way to support our work, it costs us
less to process and helps us plan in advance.
Concession: @2.50 per month
Standard donation: £5 per month
'We love ORG' donation: £10 per month
Standing Order Mandate:
Name of bank: Sort Code:
Branch:
Branch address:
Please pay The Co-Operative Bank PLC, business direct, PO BOX 250, Skelmesdale WN8 6WT
(Open Rights Group, sort code 08-92-99, account number 65185766) the sum of £______
and in words, ______________ __________________. monthly on the _____ of each
month, beginning _______ until further notice in writing and debit my account accordingly
.
Account Number: Account Name:
Signature: Date: