To: The Manager, ….………………………………………………..……Bank/Building Society

Bank Sort Code: ………… - ………… - ……………

Address of Bank/Building Society: ………………………………………………………………..

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

..……………………………………………………… Post Code: ………………………………..
With immediate effect please make the payments detailed below and debit my/our Account

Account Number: .....……………………….....……...........................................................

Name(s) of Account Holder(s): …………………………………………………………………….

Reference Code to be quoted on the payment: WWST 199……….…………………………..
(To be entered by Wycombe Wanderers Supporters Trust)

To:HSBC Bank plc, 31 Chequer Street, ST. ALBANS, Herts AL1 3YN
Branch Sort Code: 40-40-01
Credit Account: Wycombe Wanderers Supporters Society Limited Account number : 01819682

Tick one of the payment options below:

………… One payment of £150.00 (3 year membership - please enclose a cheque rather than completing the standing order)
(Please make a cheque payable to Wycombe Wanderers Supporters Society Limited)

………… One payment of £110.00 (2 year membership - please enclose a cheque rather than completing the standing order)

………… £60.00 on the 1st October every year thereafter starting on 1st October 2007 until further notice (annual membership).
(Please make a cheque payable to Wycombe Wanderers Supporters Society Limited for £60 for the current season)

………… £5.00 on the fifth day of every month following receipt of this standing order until further notice (annual membership paid monthly).
Note: To reduce administration costs please pay the £60 p.a. as a single payment - see above - if you can.

………… £ ……… on the tenth day of every month following receipt of this standing order until further notice. Please complete with the monthly amount to be paid - a minimum of £3.00 per month please. This option is available to those who are unable to pay the recommended subscription of £60.00 per year or £5.00 per month.

Signed: ……………………………………...……………………Date: ..…………………….........

Address: ……………………………………………………………………………………………….

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

……………………………………………………………… Post Code: ……………………………
Please complete and return to:
Wycombe Wanderers Supporters Trust, c/o 1 Allen Drive, Walters Ash, High Wycombe, Bucks HP14 4SS
Questions about membership or this standing order should be directed to:
Keith Blagbrough at the above address or telephone 01494 563697 or email secretary@wwst.org
Alternatively more details can be found on the website http://www.wwst.org