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Membership Form Flat Plan

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Flat plan for my membership form

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Membership Form Flat Plan

  1. 1. Membership Form Flat Plan Abygail Jones
  2. 2. 2A4F6E 647D92 C1C1C1 001526 255C69 5F838C BCBCBC 001D24 27586B 4D89A0 9BE3FE 000000 388C2F 4DC240 5CEC4D 5E9733 9BC27E 1D4300 E1E6DE 85A136 62703C 3B402E B3F400 277552 2B5240 212E29 00C069 267158 294F42 202D28 00BB7E 256E5C 294D44 1F2C29 001388 567970 32403D 020302 020302 020302 AAF8E4 ABFAC0 638B6D 3A4A3E 557870 32403D AAF8E6
  3. 3. Slogan Logo Promotional Offer Info Promotional Offer: percentage off of merchandise Renew Your Membership Name Address Home tel Mobile Email D.O.B. Membership number Direct Debit Name(s) of Account Holder(s) Bank/Building Society Account Number Branch Sort Code Name/Address of Bank/Building Society (UK banks only, The manager, bank/building society, Address, postcode) Signature Date SAS ref We can set up direct debits to start from when your current membership expires. No more wasteful reminders & no more missed pipelines. Please pay SAS direct debits from the account detailed in the instruction subject to the safeguards assured by the direct debit Guarantee. I understand that this information may remain with SAS and if so, details will be passed electronically to my bank or building society. Credit/debit card or cheque Please make cheques/postal orders payable to Surfers Against Sewage Please charge my Visa/MasterCard/Maestro/Visa Debit/Solo Card no. (19 boxes) Expiry date (4 boxes) Issue no/Valid Date (4 boxes) Security Code (3 boxes) Signature Membership Donation Total (if you aren’t able to renew your membership at this moment in time Please consider making a donation to help protect our oceans, waves & beaches) Banner Address, website, phone number, registered number +VAT for company Fundraising standards Board logo Organization identification number: 830681 Direct debit logo Payment options: I would like to pay by: Direct debit, credit/debit card, cheque Annual: £18 Unwaged, £24 single, £30 family Monthly: £1.50 unwaged, £2 single, £2.50 family, £5, £10, other (direct debit only)
  4. 4. Logo Promotional Offer Info font: Renew Your Membership Main body font: Century Gothic Payment Options Direct Debit Name(s) of Account Holder(s) Bank/Building Society Account Number Branch Sort Code Name/Address of Bank/Building Society (UK banks only, The manager, bank/building society, Address, postcode) Signature Date SAS ref We can set up direct debits to start from when your current membership expires. No more wasteful reminders & no more missed pipelines. Please pay SAS direct debits from the account detailed in the instruction subject to the safeguards assured by the direct debit Guarantee. I understand that this information may remain with SAS and if so, details will be passed electronically to my bank or building society. Credit/debit card or cheque Please make cheques/postal orders payable to Surfers Against Sewage Banner Address, website, phone number, registered number +VAT for company Fundraising standards Board logo Organization identification number: 830681 Direct debit logo
  5. 5. Slogan Logo Promotional Offer Info Promotional Offer: percentage off of merchandise Renew Your Membership Name Address Home tel Mobile Email D.O.B. Membership number Payment Options Direct Debit Name(s) of Account Holder(s) Bank/Building Society Account Number Branch Sort Code Name/Address of Bank/Building Society (UK banks only, The manager, bank/building society, Address, postcode) Signature Date SAS ref We can set up direct debits to start from when your current membership expires. No more wasteful reminders & no more missed pipelines. Please pay SAS direct debits from the account detailed in the instruction subject to the safeguards assured by the direct debit Guarantee. I understand that this information may remain with SAS and if so, details will be passed electronically to my bank or building society. Credit/debit card or cheque Please make cheques/postal orders payable to Surfers Against Sewage Please charge my Visa/MasterCard/Maestro/Visa Debit/Solo Card no. (19 boxes) Expiry date (4 boxes) Issue no/Valid Date (4 boxes) Security Code (3 boxes) Signature Membership Donation Total (if you aren’t able to renew your membership at this moment in time Please consider making a donation to help protect our oceans, waves & beaches) Banner Address, website, phone number, registered number +VAT for company Fundraising standards Board logo Organization identification number: 830681 Direct debit logo
  6. 6. Campaign poster on the back of the membership form.

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