STANDING ORDER MANDATE FOR RENEWAL

Please print out and complete the form below in BLOCK CAPITALS

To: ..............................................................................................................(your bank)

Bank's address: ......................................................................................... 
 
........................................................................................................................ 

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

Your account no: ............................................ Sort code: ........................

Name of account holder : ...........................................................................

Please pay by standing order to the account of Lawrence & Wishart at National Westminster Bank, Stockwell, London SW8, sort Code 56-00-05, account number 87658704, the sum of £27.50 immediately and £27.50 annually thereafter on
31 January each year.

NB: This replaces any previous standing order mandate you may hold for the credit of Renewal

Signed: ............................................................... Date: ....................................

Your name: ........................................................................................................

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

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

Postcode: .................................... Email: ........................................................... 

Please return form to:
Renewal, FREEPOST, LON 176, London E9 5BR (no stamp needed)