Standing Order Form - Imperial College London
Download a blank fillable Standing Order Form - Imperial College London in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Standing Order Form - Imperial College London with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Standing Order Form
Account holder’s details:
Full Name: __________________________________________________________________________
Address: __________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Email: __________________________________________________________________________
BANKER’s ORDER
To:
___________________________________________________________________(name of your bank)
Bank Address: ____________________________________________________________
________________________________________________________________________
Please pay to: “Imperial College London (SCI, Professor Alan Fenwick)” at the National
Westminster Bank, 18 Cromwell Road, London SW7 2LB, Sort code: 51-50-01, Account
number: 65824431
☐
☐
☐
The sum of £ _________ each month
quarter
yearly
From my account number: __________________________ Sort code: _______________
Starting on
: _______________________ until further notice.
(date)
Reference: SCI, Alan Fenwick (donor name, house number and postcode)
☐
☐
I would like SCI to benefit from my Gift Aid: Yes
No
Signature: __________________________________ Date: __________________
For
B ank
u se:
W hen
m aking
p ayments
i n
r eference
t o
t his
S tanding
O rder
p lease
include
t he
A ccount
H older's
n ame
a nd
t he
r eference
‘ SCI'
For office use only: IC Ref: Professor Alan Fenwick OBE, Schistosomiasis Control Initiative – to fund neglected tropical
disease campaigns.
Please return your form to:
SCI, Imperial College, Advancement Division,
SALC Mezzanine, Level 5 Sherfield Building, London SW7 2AZ
Email: giving@imperial.ac.uk
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business