Full Name………………………………………………………………………………Date ……………20…..
Address…………………………………………………………………………………………………………...
…………………………………………………………………………………………Post Code………………
Tel No.:………………………………E-Mail:……………………………………………………………………

Please complete the details above and send to Peter Babbage, 13 Brookthorn Close, Offerton, Stockport SK2 5JH enclosing cash/cheque for the appropriate amount.
Alternatively, if you wish to pay by Standing Order please complete the details below and return the whole form to: Peter Babbage, 13 Brookthorn Close, Offerton, Stockport SK2 5JH
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To: The Manager: ……………………………………….Bank Date………………….20….

Bank Address…………………………………………………………………………………

Pay to HSBC BANK PLC, 19 HIGH STREET, NORTHWICH (SORT CODE: 40-35-07)
Credit Account of CHESHlRE COUNTY CRICKET CLUB (ACCOUNT No.: 10232084)
the sum of £ …… now and for £……… on the 31st day of December in future years until further notice and debit my Account No.: ………………

Full Name: ………………………………..Address: ……………………………………………………………………………………

Signature …………………………………..

THIS INSTRUCTION CANCELS ANY EXISTING MANDATE FOR MEMBERSHIP OF CHESHIRE COUNTY CRICKET CLUB