SHIVA Charity Monthly sponsorship Standing Order Form

*Your name and address ..................................................................

................................................………….

*Your Bank/B. Society name and branch address ..................................................................

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Alliance & Leicester Commercial Bank PLC (BOOTLE)

For the credit of Schools Helping India Voluntary Association (SHIVA)

Sort Code 72-00-05 Account 32206185

* The Sum of £3 £5 £10 £.... (delete as appropriate)

* Amount in words ………………………………………….

* Starting on ....../....../...... and on the same day each month

Until further notice. *Signed............................. Date...../....../......

*Your bank account number.................................

Sort Code ……………..

*Your account in the name of

............................................................

*Please complete and post to: Bob Uppington, SHIVA charity , 19 Daventry Rd, Knowle, Bristol BS41DQ

ADD 28% GIFT AID! TAX FREE GIVING: Please sign and date below if you are a UK taxpayer and would like SHIVA Charity to treat these monthly donations as GIFT AID donations.

SIGNED…………………………………………………….. DATE ……. /…../