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BANKERS ORDER FORM

To the Manager (name and address of your bank)

Name:_______________________________________________

Address:_________________________________________________________

_______________________________________________ Post code ________

Please pay the Future in Our Hands Education and Development Fund
[Co-operative Bank Sort Code 08 92 99, Account No. 65050707] direct debits from
the account detailed on this instruction, in the sum of:

£___________ each month
commencing on ______________ (date) until otherwise

instructed by me in writing.

Name(s) of account holder(s):_________________________________________

Branch sort code _________________ Account No. _______________________

Name(s): _____________________________________________

Address: ___________________________________________________________

__________________________________________________ Post code ________


Signature:___________________________ Date _____________


Please return this form to the FIOH Education and Development Fund,
48 Churchward Ave, Swindon, Wilts SN2 1NH
(not to your bank)

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