BTG Charitable Foundation Standing Order Form

Please complete all fields marked (*)

To the Manager / Name of Bank: *

Branch Address *

Please Credit: Bishop Thomas Grant Charitable Foundation Account No: 36060568 Sort: Code: 30-90-89 Bank: Lloyds Bank, Business Banking, BX1 1LT

The Sum of: *

Monthly Payment of £10

Quarterly Payment of £30

Annual Payment of £120

Other, please specify below

If you have selected other please specify the amount

If you have selected other please specify the frequency (monthly, quarterly or annually)

Commencing on (Date): *

until further notice

Bank Account Number: *

Bank Sort Code: *

Bank Account Holder's Name(s): *

(please write your full name(s), e.g. Mrs Mary Smith & Mr Joseph Smith)

Home Address: *

Town: *

Postcode: *

Signed:

Date: *

School reference number: (for school use only) Registered Charity Number: 1175028

For more details about how we protect your privacy, our Data Protection Policy is available at https://www.btg.ac/docs/About_BTG/Policies/Data_Protection_Policy_2020.pdf. Your data will be used and stored in accordance with this policy.