Please print out this form, complete the details
and send to your bank. Thank you.

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Standing Order Authority Form
 The Bethany Project (Tanzania) UK, Reg. Charity 517995, 
Registered Address: 2 Aspen Fold  Oswaldtwistle, Lancashire. BB5 4PH, Tel: 01254 879694.
For the work of the Bethany Project, Yitwimila, Magu District, Mwanza Region, Tanznania. E.A.


On completion please post to your bank:

    To: ______________________________________________________ (name of your bank)

    Please pay to (NET) ‘The Bethany Project’

    The sum of _____

    (Amount in words) ________________________________________________________


    on the 15th day of __________________________________ (month) ___________(year)

    and then monthly until cancelled by me

    Title (Mr. Mrs. Doctor, Reverend, etc.) _____   First name: _______________________


    Surname ____________________________________


    Full postal Address: __________________________________________________________________________


    ___________________________________________________________________________


    County: ________________ Post code _____________  Country: _____________________


    Your account name: ____________________________________________________


    Your account Number: __________________________________________________


    Your Signatures: ________________________       _________________________

    Bank Use: Please pay:  ‘The Bethany Project’
    Account Number 01330624, Sort Code: 40-12-04
    When making the monthly payment please identify the payment
    using the payees surname and initial (not their account number)

    HSBC, 60 Church Street, Blackburn, Lancashire, BB1 5AS, UK
     International bank account number: GB63MIDL40120401330624
    Branch Identifier code: MIDLGB2102P

    On completion please post to your bank