FIGHT AGAINST MALARIA INFECTION
BANKER'S ORDER  (please return to the Friends of Vass)
Bank Name: ______________________________________
Full Address: ______________________________________
______________________________________
Post Code: ______________________________________
Account Name: ______________________________________
Account Number:
 ______________________________________
Bank Sort Code: ______________________________________
 
Please pay Barclays Bank Bank Plc
Sort Code: 20-80-71
Account No: 90973432
for the credit of: Friends of The Vass Medical Foundation
the sum______________ commencing on the______ day
of__________________20_____
and thereafter on the same date, until further notice.
Signature_________________________ Date______________________

Please return completed form(s) to:
The Friends of the Vass Medical Foundation, VASS FOUNDATION LTD,
145 – 157 St. John Street, 2nd Floor,
London, EC1V 4PY, UK.
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