logo Wigan Family & Local History Society
STANDING ORDER FORM for ANNUAL SUBSCRIPTIONS

Membership Cost Details per annum as at 08.11.2013

£14 for individual UK members, or
£16 for family UK members. of
£20 for overseas members

Renewal Date for all Memberships is January Each Year

Section A - Customer Account Details

Please fill in the sections below and take to your Bank/Building Society etc
Account Name
Sort Code
Account Number
Amount of Annual Payment
Membership Number of Society
Membership Name Registered with Society

Section B - Set up a new Standing Order

Beneficiary Details (who do you want to pay)
Beneficiary Name Wigan Local and Family History Society
Sort Code 40-46-32
Account Number 41883372

Section C - To Your Bank/Building Society etc

Customer Signature(s)
Customer Contact Telephone Number Date


PLEASE ENSURE YOU SIGN AND DATE THE FORM AND ENTER YOUR MEMBERSHIP NUMBER OF THE SOCIETY FOR RECORDING ACCOUNTS PURPOSES