Thanks to all who have forwarded standing order forms for this year's subscription. If you have not already paid, please print and complete this form to pay it by standing order and send it to:

CCARA Treasurer
15 Copperfields
48 The Avenue
Beckenham
Kent
BR3 5ER

If you cannot pay by standing order, please complete only your name and address and send to the Treasurer
with a cheque payable to "CCARA".

COPERS COPE AREA RESIDENTS ASSOCIATION

Subscription Form

I/We wish to join/renew my/our £1 household subscription to the CCARA.

Name(s).......................................................................................................................................................
Address.......................................................................................................................................................
.......................................................................................Post Code............................................................

To: (Name of Bank or Building Society)...................................................................................................
Branch Title (e.g. Beckenham) .................................................................................................................
Address........................................................................................................................................................
.......................................................................................Post Code..................................

Please pay the sum of £1 (one pound) on receipt of this authority to Lloyds Bank, Harbour Island Branch, 24 Harbour Exchange Square, London, E14 9GQ, Sort Code 30-13-54, for credit to the account of Copers Cope Area Residents Association, Account No. 00041000 and continue to pay similar amounts on March 1st annually, commencing in 2010, until you receive further notice from me/us in writing.

Please debit my/our account:
Account No. .....................................................
Title of Account to be debited.....................................................................................................................
Address
(if different from above)........................................................................................................................
..............................................................................................................Post Code.......................................

Date............................................... Signature............................................................

Office Use
Note to bank, please use the following payment reference:

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