I would like to apply for membership of UNAS and enclose a completed standing
order mandate.
Membership records
(Please note that this information will not be released to any person or organisation
outside the University)
First name (s):
Surname:
Title (Mr, Miss, Mrs, Ms, Dr, Prof etc):
Address for correspondence:
Telephone no:
Email address:
Graduation year and course (if Newcastle graduate):
Current occupation:
Please return both parts of this form to: unas@ncl.ac.uk
Or post to:
UNAS
School of Agriculture, Food & Rural Development
Agriculture Building
Newcastle University
Newcastle upon Tyne
NE1 7RU
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University of Newcastle upon Tyne Agricultural Society (UNAS)
STANDING ORDER MANDATE
To the Manager
______________________________________________________________Bank
Address:
________________________________
________________________________
________________________________
________________________________
Please pay:
Barclays Bank Plc
Newcastle Haymarket Branch
Account Name:
University of Newcastle upon Tyne Agricultural Society
Account Number:
70897620
Sort Code:
20-59-42
The sum of:
£15.00 (Fifteen Pounds Only)
Commencing:
1st January
And thereafter every:
1st January
Until you receive further notice from me/us in writing and debit my/our account
accordingly.
Please cancel any previous standing order in favour of the society.
Account to be debited:
Account Name:
__________________________
Account Number:
__________________________
Sort Code:
__________________________
Signature(s):
______________________________________________________
Date:
______________________
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