Please print this page, fill in your bank details in the form below and sign the form. If you know your membership number, quote it as the reference and forward the form directly to you bank; if not, post the form to: John Johnston, MOA Membership Registrar, 7 Netherfield Road, Harpenden AL5 2AF. He will then add your membership number and forward the form to your bank.
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All the above information can be obtained from your cheque book.
Signed …………………………….Print Name…………………..……….Date………………
(In accordance with bank mandate)