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REQUEST
FOR NEW STOP ORDER A.
APPLICANT: I,
the undersigned _________________________________________________________, debit
account number ______________________________, bank_______________________ branch
code ______________________ ,
hereby request you to debit my account with
on
the ________ day of each month, first payment on ____/____/_______ . My postal address:_________________________________________________________ B.
PARTICULARS OF BENEFICIARY TO BE
CREDITED: NAME
: OOSTERLAND YOUTH
CENTRE BANK
: ABSA DESPATCH ACCOUNT NUMBER : 9061914700 BRANCH CODE : 334516 C.
APPLICANT SIGN-OFF: Identity
number: ___________________________. Telephone
(work) ___________________________, cell phone _____________________
____________________________
_______________________
______________ SIGNATURE
PRINT NAME
DATE _____________________________________________________________________________ SPONSOR
A CHILD INFORMATION: Please
take my completed stop order form to the bank to make arrangements. My choice of
sponsorship is as follows:
As
sponsor you will receive the following on a quarterly basis: *
newsletter * photograph
* school report * receipts
* letter/drawing form child *
updates on Oosterland’s activities
* invites to activities/projects etc. PLEASE FAX THIS FORM TO +27 (0)41-9331207 : ATTENTION RIAAN MARAIS |
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