Standing Order Form
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Chair of the Club 2017 Honorary Secretary 2017 Ciaran Keohane Lorraine McKeaney 29 The Warren 5 Waterside Crescent, Malahide, Malahide, Co. Dublin Malahide Cricket Co. Dublin Tel (M): 085 7311 462 Email: [email protected] Club Email: [email protected] www.malahidecc.com Patron: Norman J. Adams Club Tel: +353 1 8450607 President: Phil Roche
Standing Order Form Date: / / 2017
To: The Manager
Bank:
I/We hereby authorise and request you to debit my/our account no ______and to Credit:
MALAHIDE CRICKET CLUB No.1 Account ACCOUNT NUMBER: 42782062 AT: Allied Irish Banks, Church Road, Malahide, County Dublin. SORT CODE: 93-25-23
UNDER REFERENCE (Player’s or family name)
As detailed hereunder – (tick the relevant category) Tick the Standing Order Amount Category Total Amount: Category Each Month (for 5 months) Men Playing €39.00 Lady Playing €28.00 Student €24.00 Family €68.00 Ordinary €30.00 Senior Citizen €20.00 Schoolboy/girl €20.00
Please debit my / our account with five (5) equal payments of €______commencing on
______2017 and terminating on ______2017 making a total of
______Euro €______. It shall be understood that the Bank shall not be under any liability for damage or loss caused by omission to make these payments.
Signed
PLEASE RETURN THIS FORM TO YOUR OWN BRANCH AND SEND A COPY TO:
Club Registrar: Marianne Herbert, 28 Seabury Park, Malahide, Co Dublin Tel: (M) 086 4066 266 email: [email protected]
Honorary Treasurer: Kevin McPhilemy, 11 Beverton Wood, Donabate, Co. Dublin.