Standing Order

Please return to Hopefield Animal Sanctuary Office, 697A Green Lane, Dagenham, Essex RM8 1UU

Date	......................................................
To (Bank Name)	......................................................
Address	......................................................
	......................................................
	......................................................
Bank Account Number	......................................................
Please pay the sum of	£.....................................................
in words	......................................................
To Barclays PO Box 96, Ilford, Essex IG2 6BU
For the credit of Hopefield Animal Sanctuary
Sort Code (To be completed by Hopefield Animal Sanctuary)
Account Number (To be completed by Hopefield Animal Sanctuary)
On the ............ day of .................................. 2009
and on the same day annually/monthly/weekly until further notice charging my account.
Signature	......................................................
Full Name	......................................................
Address	......................................................
	......................................................
	......................................................